Report

Feeling the Pulse A Study of the Total Sanitation Campaign in Five States WaterAid’s mission is to overcome poverty by enabling the world’s poorest people to gain access to safe water, sanitation and hygiene education

© WaterAid India, November 2008

Advisor S.S. Meenakshisundaram, IndiaWASH Forum

Coordination and Editing Indira Khurana and Romit Sen, WaterAid

Report writing and Photographs Study Team, Knowledge Links Pvt. Ltd.

Inputs Mamita Bora Thakkar, Maria Fernandez, Anand Shekhar, Pratibha Singh, George Fernandez, Hemalatha Patil, WaterAid

Any part of this publication my be translated or reprinted with due acknowledgment to WaterAid, India

Published by WaterAid India C-3, 1st Floor, Nursery School Building Nelson Mandela Marg, Vasant Kunj New Delhi – 110070

Design and Printing Macro Graphics Pvt. Ltd. A-36, C.R. Park New Delhi 110019 www.macrographics.com CONTENTS

Acknowledgements 1

Preface 2

Acronyms 4

Executive Summary 6

Section-1: Main Report 13 Total Sanitation Campaign (TSC) 15 1. Study Methodology 16 2. TSC: Coordinates of a Reform Initiative 18 3. Key Findings 21 4. Subsidy and Incentive: Perceptions and Realities 31 5. IEC and Behaviour Change 35 6. Inclusion, Equity and Gender Relations 37 7. Technology and Safe Sanitation 40 8. Nirmal Gram Puraskar (NGP) 44 9. Role of Civil Society Organisations 47 10. What has worked and what has not 49 11. Emerging Directions: Targets, Triggers and Total Sanitation 52

Section-2: State Reports 55 2.1 Bihar 57 2.2 Chhattisgarh 61 2.3 Haryana 67 2.4 Karnataka 72 2.5 Tripura 77

References 81

Glossary 82

Annexes 85 Annex I: List of GPs visited 87 Annex II: Primary Data on Household Toilets and Usage 89 Annex III: Study Framework and Tools 92 Annex IV: FGD Guide for Community Level Consultation 99

Acknowledgements

The seeds of this study on the Total Sanitation facilitated village visits on a very short notice. Campaign (TSC) were sown with a suggestion We also thank them for their very useful made by the IndiaWASH Forum. suggestions and advice in conducting fi eld trips. This report is the outcome of a study undertaken to understand the principles of Secretaries of line departments and their what has worked and what has not worked heads of departments were very welcoming in TSC which is the national programme on and helpful in accessing the individuals to reforms in rural sanitation launched by the be interviewed and institutions to be visited. Government of India in 1999. The focus of Their interest and encouragement made things this study is to draw learning lessons from easy for the members of the study team. the implementation experience so far, for improved effectiveness in the future. We would like to express our special gratitude to Dr. S.S. Meenakshisundaram who has been The study team is immensely grateful a great help in keeping the study focused and to women, men and children of 40 Gram also on drawing lessons learned for improved Panchayats in 20 blocks of 10 districts programme planning and implementation in across 5 states of Bihar, Chhattisgarh, future. Haryana, Karnataka, and Tripura, who spared their valuable time to share their The study team accepts that none of the stories of sanitation. We say a big ‘thank individuals and institutions acknowledged you’ to the engineers and functionaries of are in any way responsible for any limitations, line departments in all the study districts errors or inadequacies in the report, for and states, who invested energy and time which the study team members are solely in identifying study blocks and GPs and responsible.

Acknowledgements 1 Preface

Sanitation as a matter of development priority 1999. TSC represented a shift from a high to gained importance globally in 1980s following low and no subsidy regime in the provision the declaration of the International Water of rural sanitation services to begin with. and Sanitation Decade (IWSD) by the United This was taken further and the term subsidy Nations. In view of emerging requirements in was dropped in TSC Guidelines of 2004 to the sector and in line with India’s commitment be replaced by the term incentive. As per to the IWSD and national requirement, the the latest TSC Guidelines of 2007, ‘incentive Rajiv Gandhi National Drinking Water Mission as provided under the scheme may be (RGNDWM) was set up by Government of extended to Below Poverty Line (BPL) families India (GoI) in 1985. Along with rural water if the same is considered necessary for full supply, RGNDWM was also given the mandate involvement of the community’. The stated to streamline rural sanitation initiatives in strategy of TSC is to make the Programme the country. Given the global and national ‘community led’ and ‘people centered’. developments in the sanitation sector, Central Rural Sanitation Programme (CRSP) was Inclusion of sanitation as one of the conceived and launched as a country wide Millennium Development Goals (MDGs) initiative in 1986. in 2002 following the Earth Conference in Johannesburg intensifi ed the sanitation CRSP aimed at creating sanitation agenda in India as well. But the sanitation infrastructure at the individual household and uptake in the country still remained fairly community level by providing full subsidy for low till about 2003-04. With the institution the purpose. The inherent policy perception of a post achievement reward scheme called entailed looking at people as benefi ciaries Nirmal Gram Puraskar (NGP) in 2003, the and provision of sanitation goods and services pace of sanitation coverage accelerated in primarily as state responsibility. However, the following year. Beginning with fi rst NGP despite one and a half decades of CRSP being awards in 2004-05, TSC has come to be in place, rural sanitation coverage in the increasingly recognised as an NGP programme country was a meager 22%, as per Census with a lot of prestige attached to it, as the of India 2001. It was clear that CRSP had award is given to the winning GPs, individuals not delivered the desired results. A baseline and organisations by the President of India. survey on water and sanitation conducted by NGP goes beyond coverage to identify and the Indian Institute of Mass Communication award an open defecation free and clean (IIMC) in 1998 revealed that only 2% of the village environment. The number of NGPs benefi ciaries found subsidy to be a motivating awarded has dramatically shot up from 41 in factor for construction of toilets and around 2005 to 10,094 in 2008. 55% of the people having private toilets were self motivated. It also indicated that around TSC has been on for almost a decade now. 60% of the people were willing to pay for However, there are few studies to indicate sanitation services in the rural areas of the whether TSC has been delivering the results country. it set out to in general and what has worked or not worked in TSC so far in particular. It In response to the emerging learning in the was felt that a study of this nature would sector, CRSP was revamped and launched yield signifi cant policy learning and generate as the Total Sanitation Campaign (TSC) in valuable insights for improving the programme

2 Feeling the pulse implementation strategy for TSC at the the existing literature in the sector comprising national and state levels in the years to come. review reports, studies, country papers, and In view of this felt need, the idea of a rapid other relevant documents. It also builds qualitative assessment of TSC was conceived on the primary qualitative data generated by WaterAid India (WAI) in the beginning of during fi eld visits to 40 GPs in 20 blocks 2008. As WAI has been working closely with across 10 districts of 5 states (2 each from a the government and civil society organisations state) in India. Study states included Bihar, on innovative people led initiatives in water Chhattisgarh, Haryana, Karnataka, and Tripura. and sanitation in India since mid eighties, the In each state, consultations were held with decision to commission this study was taken the state governments to begin with. Periodic with the objective of generating strategic discussions were held with WaterAid staff in the learning on rural sanitation initiatives at the Country offi ce and the Regional Offi ces as well. national level in the country. The study recognises that TSC has been the The terms of reference for the study was most signifi cant rural sanitation initiative at developed by WAI through an iterative the national level in India so far and carries a process involving multi stakeholder wealth of learning on policy and programme consultation including Government of India. issues about doing sanitation on scale. Dr. S.S. Meenakshisundaram, former Secretary to the Ministry of Rural Development, Various approaches and strategies adopted Government of India provided strategic advice. for the implementation of TSC across states Knowledge Links was engaged to undertake and districts have a lot to tell about what the study across 5 sample states selected in works and what does not work in different consultation with the Government of India. contexts and conditions. Criteria for selection of states included good and bad performing states in terms of We believe that the study fi ndings and achievement in sanitation coverage as per the recommendations carry useful insights data available on the web site of Department about emerging issues and challenges of Drinking Water Supply and also the regional in the implementation of rural sanitation representation from across the country. programmes in India, which could be of interest and relevance in other similar country The study draws heavily on the secondary contexts as well. data available on GoI’s DDWS website and WaterAid India

Preface 3 Acronyms

ADC Additional Deputy Commissioner

APL Above Poverty Line

ASHA Accredited Social Health Activist

BCC Behaviour Change Communication

BDO Block Development Offi cer

BP Block Panchayat

BPL Below Poverty Line

CBO Community Based Organisation

CC Climate Change

CCDU Communication and Capacity Development Unit

CEO Chief Executive Offi cer

CLTS Community Led Total Sanitation

CM Chief Minister

CRSP Central Rural Sanitation Programme

CSID Central Statistical Information Department

DDC District Development Commissioner

DDWS Department of Drinking Water Supply

DM & DC District Magistrate and District Collector

DRR Disaster Risk Reduction

DWSC District Water and Sanitation Committee

EE Executive Engineer

E-n-C Engineer-in-Chief

GoI Government of India

GO Government Order

GP Gram Panchayat

HSL Household Sanitary Latrine

4 Feeling the pulse ICDS Integrated Child Development Scheme

IEC Information Education Communication

IHHL Individual HouseHold Latrine

JP Janpad

KL Knowledge Links

MDG Millennium Development Goals

NGO Non-Governmental Organisation

NGP Nirmal Gram Puraskar

NRHM National Rural Health Mission

ODF Open Defecation Free

PC Production Centres

PHED Public Health Engineering Department

PRIs Panchayati Raj Institutions

PRA Participatory Rural Appraisal

PR & RDD Panchayati Raj and Rural Development Department

RGNDWM Rajiv Gandhi National Drinking Water Mission

RSM Rural Sanitary Mart

SDM Sub Divisional Magistrate

SHG Self Help Group

SSHE School Sanitation and Hygiene Education

SWSM State Water and Sanitation Mission

TSC Total Sanitation Campaign

UNICEF United Nations International Children’s Emergency Fund

VWSC Village Water and Sanitation Committee

WAI WaterAid India

ZP Zilla Panchayat

Acronyms 5 Executive Summary

The study, commissioned by WaterAid India, sanitation scenario in the rural areas of the carries an independent qualitative assessment country resulting in positive public health of Government of India’s Total Sanitation outcomes. Campaign (TSC) launched in 1999. TSC is a country wide, community based and demand Lessons learnt from Central Rural Sanitation driven sanitation initiative aimed at improving Programme (CRSP) implemented in India the quality of life in the rural areas of the during 1986-1998 made it clear that subsidy country. for toilet construction does not automatically result in desired sanitation coverage and The inquiry seeks to unpack what constitutes the resultant public health benefi ts. This the core of TSC programme design and was amply borne by the fact that even after inherent policy implications on one hand and more than a decade of CRSP being in place, understand what has worked and not worked rural sanitation coverage in India remained a in TSC so far on the other. The purpose has meager 22%, as per the Census of India 2001. been to generate strategic learning from a A process of radical rethinking had already policy and programme design and delivery begun in late 90’s that lead to a restructuring perspective, which may be used to inform TSC of the national rural sanitation programme in programme implementation strategy at the the form of Total Sanitation Campaign (TSC). national and state levels in the years to come. TSC embodied a shift from a high to low and no subsidy regime in the provision of rural The study draws heavily on the available data sanitation services. at Government of India’s web site ‘ddws. nic.in’ and the existing literature in the form The proposed strategy for TSC of country papers, review reports, studies, implementation, as per the Guidelines of and other documents. Besides, fi eld visits 2007, is to make the programme ‘community were made to 40 GPs in 20 blocks across led’ and ‘people centered’. A demand driven 10 districts in 5 states selected on the basis approach is to be adopted with increased of a stratifi ed purposive random sampling. emphasis on awareness creation and The criteria for state selection included good demand generation for sanitary facilities at and bad performance and adequate regional the household, community and institutional representation. Field study began with levels. The end objective is to have a clean discussions at the state level. Methods used and safe village environment. It is assumed for generating qualitative information included that community mobilisation is the key to focus group discussions, in-depth interviews creating safe and sustainable sanitation and discussions. Throughout, discussions services. Rural school sanitation is a major were held with WaterAid staff in Delhi and the programme component and an entry point for regions. wider acceptance of sanitation by people in the rural areas.

TSC: A Reform Initiative The TSC is designed to take care of both demand and supply sides of rural sanitation: TSC has been the most signifi cant reform while IEC activities are supposed to generate initiative in the rural sanitation sector in India demand by creating awareness, Rural Sanitary so far and has the potential to transform the Marts (RSMs) and Production Centers (PCs)

6 Feeling the pulse are envisaged to supply material (such as There are variations across states and cement, bricks, pans, squatting plates, foot districts in terms of approaches and rest, P-traps etc) for construction of IHHLs strategies adopted and results achieved and institutional toilets in schools and as well. There are three broad type of anganwadis and other sanitary facilities and approaches in use: one that relies on provide related guidance. Solid and Liquid conventional IEC with tools like posters, Waste Management component (included in pamphlets, wall writing, TV, radio, folk the TSC Guidelines of 2007) of the programme media, and inter-personal interaction seeks to achieve the general cleanliness of and which has been popular in most of villages. the states and districts; two where some states like Haryana and Chhattisgarh have TSC is proposed to be implemented by adopted innovative participatory approach Panchayati Raj Institutions (PRIs) at all levels, called Community Led Total Sanitation to ‘carry out the social mobilisation for the (CLTS) aimed at creating open defecation construction of toilets and also maintain the free communities by engaging them in clean environment by way of safe disposal of participatory analysis of their sanitation wastes’. NGOs’ role is conceived to be in terms situation leading to collective local action; of their active involvement in IEC activities three in which the programme including the on one hand and in provision of required IEC activities has been implemented in a hardware for toilet construction through RSMs state led and target driven fashion without and PCs on the other. any conscious effort to create required awareness at the community level. In this Given that TSC is almost a decade old now category IEC activities have been undertaken and the campaign will come to an end in in a routine administrative fashion as more 2012, a review at this stage provides scope for of a fund utilisation exercise, not organically means of accelerating progress and making linked to awareness creation and demand corrections if needed. generation processes.

Some states have their own state specifi c Policy, Programmes, and Progress sanitation programmes as well, like Maharashtra and Bihar have Sant Gadge The study reveals that there are signifi cant Baba Swachata Abhiyan (SGBSA) and Lohiya policy variations across states. For instance, Swachata Yojana (LSY) respectively. While of the 5 sample states studied, while SGBSA is based on the strategy of healthy Karnataka, and Tripura follow TSC Guidelines competition among GPs to promote clean to offer suggested incentive only to BPL villages, LSY is a subsidy driven programme households, Bihar and Chhattisgarh have aimed at accelerating the pace of sanitation made additional provision for subsidy to coverage in rural areas. APL households as well from their own resources. Haryana has consciously down Available data suggests that high subsidy played subsidy/incentive as they perceive has not really worked in the case of TSC: it to be subversive of community processes states such as Bihar and Chhattisgarh even in general and the spirit of collective local with a high subsidy regime have the current action in particular. coverage of IHHLs only at 22.17% and 32.63%

Executive Summary 7 respectively, which is lower than the country roles and functions of different civil society average of 55.69%1 on one hand, and much organisations. lower than Haryana, which has the current coverage at more than 70% and where subsidy NGOs have been engaged both as element has been apparently under played to community/social mobilisation agencies achieve faster results. (Chhattisgarh, Haryana, Karnataka and Tripura) involved in IEC activities and However percentages, while suggesting a hardware suppliers and construction defi nite trend in effort and achievement, may contractors (Bihar). In some places there has not tell the entire story, as there would be been an apparent mistrust in NGOs capacities important variations in terms of the absolute to deliver, as also in their integrity such as in number of people achieving access to basic Durg and other districts of Chhattisgarh. SHGs sanitation across states depending on the size have been involved in social mobilisation of population involved to begin with. efforts and in credit fi nancing of toilet construction. Institutional Arrangements Nirmal Gram Puraskar (NGP) There are two broad trends by way of institutional arrangements in place at the level NGP is a post achievement award scheme of state governments for TSC implementation, meant for GPs, individuals and organisations. In some states (Haryana and Karnataka) TSC is There is considerable prestige attached to being implemented by Panchayati Raj or/and it, as it is given by the President of India to Rural Development Departments, whereas winning entities. GPs that qualify are those, in some other states (Bihar, Chhattisgarh which have become open defecation free and and Tripura) it is being implemented by fully sanitised. Aspects that constitute the pre- Department of Drinking Water Supply and conditions for NGP application include 100% Sanitation or Public Health Engineering open defecation free (ODF) status including Department. total coverage of IHHLs, 100% school and anganwadi sanitation and a clean village Role of Panchayati Raj Institutions (PRIs), environment. NGOs and Community Based Organisations (CBOs) such as Self Help Groups (SHGs) of NGP seems to have worked in accelerating women in TSC implementation on the ground the coverage, as it was introduced in 2003-04 also varies across states and districts. PRIs and the pace of sanitation coverage in most have been spearheading the campaign in of the states has picked up since 2004-05, states like Haryana and Karnataka, but in a year after NGP launch. However, there are states like Bihar, Chhattisgarh and Tripura, growing concerns around the veracity of their role have been relatively limited. ODF status of GPs with NGP award and its Moreover, there are signifi cant variations sustainability. There have been reports of across districts within states in terms of the manipulations and misrepresentations that also get past the verifi cation process thereby 1 Percentages in the paragraph are worked out on the undermining the credibility of the award in basis of data available on GoI’s website ddws.nic.in as on 10 October 2008. many cases.

8 Feeling the pulse Key Findings Approaches and strategies adopted to pursue sanitation vary considerably across The key study fi ndings are as follows: states, at times, not really in line with the stated TSC strategy of the programme Guidelines and their Adoption being ‘community led’ and ‘people There is signifi cant disconnect in terms centered’. of intent and action: whereas the TSC States that have done relatively well guidelines mention that the programme have inspired leadership at the state and has to be community led and people district levels; committed champions and centered, actual implementation on community leaders; strategies based the ground is largely state led and on social/community mobilisation; and, target driven with the line departments effective monitoring of TSC activities at the functioning as major drivers of the district and village level. programme. In states and districts where PRIs have There has been limited involvement of been actively involved in TSC, the other stakeholders such as PRIs and results have been quicker and more Civil Society Organisations (CSOs) in TSC sustainable. implementation, though there has been There is a lack of awareness of disaster relatively better involvement of PRIs in risks related to fl oods, droughts, Chhattisgarh and Karnataka, and CSOs in earthquakes, landslides, cyclones and Haryana. other events, and their possible impact Though there are exceptions, there has on sanitation facilities at the household been a general mistrust about the role of and community levels. Similarly, climate NGOs in TSC, though more pronounced in change and the resultant adaptation Bihar and Chhattisgarh. needs of people are also not considered and addressed in planning and creating Results and Realities sanitation facilities. TSC has shown remarkable progress in There are threats of inappropriate rural sanitation coverage since 2004-2005; technology options for construction of NGP, launched in 2004, seems to be the toilets contaminating sub-surface water major factor in accelerating the pace of sources, thereby increasing the risk of coverage. avoidable morbidity and mortality. In fact, A large number of NGP villages are neither technology has emerged as a major factor (ODF) nor fully sanitised, which is one of in safe sanitation, and has yet to get the the qualifying criteria for NGP application. attention it deserves. This suggests that NGP verifi cation Inclusion of women, poor and the processes are not always sound and are marginalised in total sanitation is skewed open to manipulation or/and errors. and undertaken on fairly unequal terms: TSC is getting increasingly state led and in places visited in Bihar for example, target driven; one of the stated reasons no consultation with the poor dalit has been the pressure of achieving communities even in NGP villages had sanitation MDG targets ahead of time i.e. taken place and women were not even by 2012. aware of the programme.

Executive Summary 9 What has worked What has not worked Supportive policy environment, sound Subsidy for hardware to individual strategy, appropriate institutional households has not worked in promoting arrangement, and suitable and timely sanitation. The connection between training and capacity development have subsidy and sanitation coverage is weak as made substantial contribution to the the states such as Bihar and Chhattisgarh success of the TSC programme in terms of with a higher subsidy regime (both have achieving faster and sustainable results provision of additional state subsidy for in states like Chhattisgarh, Haryana and APL households as well) have a relatively Karnataka, and reduced rate of coverage than other states Commonalities across all the well such as Haryana, Karnataka, and Tripura, performing districts and states like Sarguja which have kept themselves limited to the (Chhattisgarh), Sirsa (Haryana), and GoI norm of incentive money only for BPL Shimoga (Karnataka) include an intense households. campaign, driven by mass mobilisation and In states and districts where civil society involvement of a number of civil society engagement has been weak, the pace of organisations like PRIs, NGOs, CBOs, sanitation coverage has been slow, and SHGs and a dedicated cadre of trained the construction and usage of sanitary programme functionaries and volunteers. facilities have been of poor quality. Meticulous planning and close monitoring Solid and liquid waste management and in districts that have done well in all the 5 hygiene education components of the states. programme have yet to pick up, as they Mobilised communities and community have been largely neglected in most of the leaders have made a great difference in states as a result of TSC being seen primarily inspiring other communities to act and as an IHHL construction programme. achieve total sanitation in their villages. Focus on school sanitation without Widespread use of community led total adequate emphasis on hygiene education sanitation (CLTS) approach across districts as a part of the SSHE component of the (Bhiwani, Panipat, Sirsa and others) in programme has not resulted in required Haryana has worked well, leading to an behaviour change in most of the places. increase in the pace of coverage from Financial and physical monitoring as an around 39% to more than 70% between indicator of safe environment. 2006-08. School sanitation in Sarguja district of Chhattisgarh with its features of Monitoring and Learning monitoring chart for daily monitoring The thrust simply on coverage seems to of sanitation and hygiene practices of be inspired by the current monitoring children, bamboo fencing to protect indicators at both state and national level the school toilet from cattle and other which is based on numbers or percentage intruders, and use of force lift pumps to of coverage. It is not designed to capture ensure the availability of water in school either usage or behaviour change, which toilets has worked well with a marked is the stated thrust of the programme. improvement in sanitation behaviour Neither has the outcome been monitored. change of school going children. Overall the focus has been to ensure

10 Feeling the pulse latrine coverage and the promotional Ecological sanitation or ecosan has been strategy in many states has omitted the conspicuous by its absence in all the linkage between improved sanitation study states. Ecosan holds promise for the leading to improved water quality and future, as it offers eco-friendly solutions improved health. by treating human waste as resource. In Technology innovation has not been given states like Tamil Nadu ecosan has been the desired push and ‘one size fi ts all’ successfully tried out. approach has been adopted irrespective of geographical and climatic conditions by- passing customer preference in some cases. Recommendations

In view of the fi ndings of the study, the Emerging Requirements following recommendations are made to Well designed implementation strategy, optimise the benefi ts of TSC: dedicated cadre of staff and volunteers, and close monitoring are emerging as Policy major requirements, for success of TSC. TSC is currently a guideline. A national Quality of construction of toilets is sanitation policy that clearly articulates emerging as one of the critical factors in Government of India’s policy and position ensuring usage and sustained behaviour need to be in place. This policy needs to change. However, technology has yet to address various issues such as inclusive be recognised as a major factor in safe processes, investment priorities, expected sanitation at the guideline and programme public health outcomes and their implementation level. monitoring, menstrual hygiene, subsidy/ Approximately 50 per cent of the incentive, institutional arrangements population in the country are women. including role of PRIs, CSOs, and Though extremely important, menstrual communities, community mobilisation hygiene is not included as a part of the TSC approaches, technology as a factor in safe programme design. It has been taken up sanitation. In the current context, possible as a part of programme activity in Haryana, impacts of disaster including climate where it has received overwhelming change on provision of sanitation services response from women’s groups. SHGs and appropriate solutions needs to be have been trained to produce and market identifi ed. sanitary napkins for women and make it available to them on affordable prices. Programme Design and Delivery Rural Sanitary Marts that have facilitated TSC implementation strategy is revisited people’s access to pans, P-traps and and revised to focus more on usage of other hardware components mobilised sanitation facilities created and the related from different suppliers as per local need behaviour change so as to achieve the and demand have done much better than objective of improvement in the quality of Production Centers, which have been life of people in rural areas. The revision promoting uniform designs of squatting needs to be made in terms of making plates and other hardware, without much the programme truly community led and room for local innovation. demand driven as against the state led and

Executive Summary 11 target driven approach being adopted in Menstrual hygiene is included as a several states and districts currently. programme component of the campaign. States and districts could place greater emphasis on strategy development Institutional Actors and Agencies and effective action planning for TSC Effective and timely realisation and implementation followed by monitoring, utilisation of funds allocated for sanitation follow up and corrective action, as required. through the removal of bottlenecks and In line with the stated TSC strategy of wherever needed, capacity building. the programme being ‘community led’ PRIs are oriented and strengthened to and ‘people centered’ and in view of the engage communities in self analysis of success of CLTS in Haryana, community led their sanitation situation followed by total sanitation (CLTS) could be one of the collective local action to achieve the approaches explored for faster and more objectives of total sanitation. sustainable results on the ground. NGOs and CBOs such as SHGs are actively Ecosan could be one of the options while involved in community/social mobilisation, sharing technology options with the school sanitation and hygiene education, communities in the process of planning for monitoring of programmes and outcomes. ODF and fully sanitised environment. Champions and community leaders Planning for total sanitation at the other than GP Sarpanches are actively community level is also based on considered for felicitation under NGP so hazard and risk assessment at the local as to keep motivation levels high. These level related to possible disasters and champions could also include government emergencies such as fl oods, drought, offi cials. earthquake, landslides and cyclones. An assessment of the possible impact Monitoring and Learning of climate change and the resultant Deepening of monitoring by taking it adaptation needs of communities to beyond coverage to include usage, provision of sanitation facilities. behaviour change, and health benefi ts The IEC component of the programme is accrued because of TSC. This could be re-oriented to engage in more effective done by complementing on line TSC behaviour change communication (BCC) monitoring system with periodic fi eld strategies, which have been more of based reviews and community monitoring rhetoric than reality so far. IEC needs to systems. Community based water quality focus more on establishing a link between monitoring through convergence with improved sanitation and its impact on the the Rajiv Gandhi National Drinking Water collective health to ensure sustained use Quality Monitoring and Surveillance of the sanitation facilities created. Programme could provide data on Incentive/subsidy money is used to award immediate impact of sanitation. rural communities after they are open Design and implement a system to defecation free and fully sanitised and not recognise and encourage local technology to individual households. innovations suitable to particular climatic, Special focus on engagement with and social and geographical conditions. meeting the needs of marginalised groups Develop on effective community strategy such as women, tribals, Scheduled Castes that mobilises communities, addresses all the disabled and the aged. concerns and offers cross learning.

12 Feeling the pulse Section 1 Main Report

Total Sanitation Campaign (TSC)

‘Total Sanitation Campaign is a comprehensive programme to ensure sanitation facilities in rural areas with broader goal to eradicate the practice of open defecation. TSC as a part of reform principles was initiated in 1999 when Central Rural Sanitation Programme was restructured making it demand driven and people centered. It follows a principle of “low to no subsidy” where a nominal subsidy in the form of incentive is given to rural poor households for construction of toilets. TSC gives strong emphasis on Information, Education and Communication (IEC), Capacity Building and Hygiene Education for effective behaviour change with involvement of PRIs, CBOs, and NGOs etc. The key intervention areas are Individual household latrines (IHHL), School Sanitation and Hygiene Education (SSHE), Community Sanitary Complex, Anganwadi toilets supported by Rural Sanitary Marts (RSMs) and Production Centers (PCs). The main goal of the GoI is to eradicate the practice of open defecation by 2010. To give fi llip to this endeavor, GoI has launched Nirmal Gram Puraskar to recognise the efforts in terms of cash awards for fully covered PRIs and those individuals and institutions who have contributed signifi cantly in ensuring full sanitation coverage in their area of operation. The project is being implemented in rural areas taking district as a unit of implementation’.

Source: ddws.nic.in

Total Sanitation Campaign 15 1. Study Methodology

An independent country wide study of Sample Selection and Methodology Government of India’s Total Sanitation Campaign (TSC) was commissioned by Five sample states were identifi ed after WaterAid India in April 2008. Supported discussions with Rajiv Gandhi National by WaterAid the study was undertaken by Drinking Water Mission (RGNDWM), on Knowledge Links, India during May-August the basis of the key performance indicator 2008. The purpose of the study has been to of individual household latrine (IHHL) generate strategic learning by identifying coverage (DDWS data base). Both the better triggers, barriers and key challenges in performing and poor performing states were achieving TSC objectives, defi ne options for selected. Thus, Bihar, Chhattisgarh, Haryana, ensuring long term sustainability of Karnataka and Tripura were identifi ed for TSC outcomes, and identify policy the study. Across each state, two districts, implications. four blocks and eight Gram Panchayats were selected again on the basis of good and bad The study was planned and carried out as a performance. However, the fi nal districts rapid qualitative assessment of TSC, which and their sub-regions were fi nalised in has been in implementation for a little consultation with the concerned state offi cials; more than 8 years now since its inception approach to sampling was kept open and in 1999-2000. It entailed comprehensive fl exible so as to appreciate and capture state literature survey followed by study visits specifi c dynamics. to 5 sample states of Bihar, Chhattisgarh, Haryana, Karnataka, and Tripura during May- Whereas in Chhattisgarh, Haryana and August, 2008. The study was carried out by Karnataka, changes were made in pre-selected a team from Knowledge Links comprising 6 sample districts following consultation with professionals, joined by 2 representatives the state level programme managers, in Bihar from WaterAid, one each in states of Bihar and Tripura, districts remained the same and Tripura respectively. as selected through the agreed sampling methodology to begin with. The core objective of the exercise was to examine the approaches and strategies In Chhattisgarh although the study team adopted by various states for implementation had initially short listed Korba as the best of the programme and assess their performing district and Durg as the poorest performance in terms of what has worked and performing one, this was eventually changed what has not worked in the respective states. to Sarguja and Dhamtari, because the former, More specifi cally the study was designed although an average performance district, had to focus on: effectiveness of the campaign; shown impressive progress over the last one barriers and drivers of the campaign; status year and the later, as per the DDWS data was of NGP villages; and policy implications the best performing district. for improved implementation. The study has tried to address key components of Similarly in Haryana, initially selected districts the programme in terms of activities at all were Panipat (best performing) and Jind (worst the levels of planning, management and performing), which were replaced by Sirsa implementation. (the entire district being reportedly open

16 Feeling the pulse defecation free) and Mewat (the most diffi cult The study was undertaken within a district) on the advice of the State Coordinator specifi cally constructed framework TSC, Haryana. In Karnataka, Mandya was that included interviews with multiple replaced by Bidar on the suggestion of stakeholders at the state, district, block and the concerned secretary, Government of gram panchayat level including discussions Karnataka. with the community and visits to the project villages; semi structured questionnaires In Bihar and Tripura, originally selected and checklists were prepared for the districts were retained. District visits in Bihar various interviews including the ones at the to Vaishali and Nalanda and in Tripura to North community level. The study team also visited Tripura and Dhalai were made. schools and Anganwadis.

Study Methodology 17 2. TSC: Coordinates of a Reform Initiative

‘The strategy is to make the programme ‘community-led’ and ‘people centered’. - TSC Guidelines Jan 2004/Dec 2007

Sanitation in India is a state subject. This It had already become increasingly clear implies that all the policy and programme that CRSP was not being able to deliver decisions and investments regarding the desired results. And this was further sanitation are supposed to be made primarily validated by a study undertaken in 1998 by the state governments. However, the fact (Water and Sanitation: A baseline Survey; that sanitation has been a matter of major Indian Institute of Mass Communication), policy concern for Government of India (GoI) which made three critical observations that for more than two decades now underscores are as follows: its growing importance at the level of central 55% of the private toilets existing at that government. The GoI launched Central Rural time were self motivated Sanitation Programme (CRSP) in 1986 soon Only 2% state that subsidy was the after setting up of Rajiv Gandhi National motivation for constructing a toilet, Drinking Water Mission in 1985. The Mission whereas 30% were motivated by the itself came about in the wake of India’s convenience and 21% privacy that a toilet commitments to the International Water and in the house offered. Sanitation Decade declared by the UN in 1980s Most importantly, 40 % of the rural and national priorities. households were also willing to contribute about Rs. 500 for the construction of a GoI’s role in rural sanitation, in initial three toilet, while some 20% households were decades after Independence i.e. ’50s, ’60s even willing to pay more. and ’70s, was limited to making some fi nancial provision for construction of latrines Based on these key fi ndings CRSP was in rural areas and urging state governments radically redone to launch a community to take necessary steps to promote rural based, people centered and demand driven sanitation. programme called Total Sanitation Campaign (TSC). TSC was launched in 1999 across 400 CRSP was the fi rst country wide programme districts in the country to begin with and was in sanitation fi nancially supported by GoI. It extended to 200 more districts over next 5-6 focused on creating sanitation infrastructure years. Thus TSC now covers 600 of total 611 at the household level in rural areas by districts in the country across 28 states and 7 subsidising the construction of latrines/ union territories. toilets. To begin with, CRSP was conceived as an initiative to strengthen the State Rural Besides, throughout the 1990s some critical Sanitation Programmes (SRSPs), being bilateral and international agency supported implemented by state governments. In 1993, projects were also being implemented in GoI revised the CRSP guidelines to provide several parts of the country (for example, higher budgetary allocations to accelerate Dutch supported projects in UP, AP, Kerala, the pace of coverage. But despite 15 years of Karnataka; World Bank supported projects in CRSP being in place, rural sanitation coverage Karnataka and UP, etc.), wherein community in 2001, as per Census of India, remained a participation and minimum subsidy were key disappointing 22%. strategic inputs.

18 Feeling the pulse Addressing Demand and Supply are equally or even more important to realise the full benefi ts of sanitation, particularly TSC made a shift from a supply led to a public health outcomes. demand driven approach with focus on creation of awareness and demand generation Though human resource development (HRD) as the basis for providing rural sanitation. is not a separate programme component, Though TSC was launched a year before CCDUs set up in states with the fi nancial help millennium development goals (MDGs) were from Government of India are supposed to declared by the United Nations in 2000, it undertake upgradation of knowledge and acquired a greater sense of urgency and skills of existing human resource across purpose after the inclusion of sanitation as a different states for the national programmes part of Target 10 in MDG 7 following the World in water and sanitation including that for Conference on Sustainable Development at TSC. This is become HRD is based on the Johannesburg in 2002. understanding that human and institutional capacities are critical for achieving the A broad look at the structure of the programme desired sanitation outcomes. NGP is the post suggests a perspective where state agencies achievement community award instituted in are supposed to be driving both the demand 2003 and made operational in 2004-05. and supply sides of the programme by stimulating awareness and demand on one Besides the national TSC programme, some hand and by streamlining the delivery chain for of the state governments have their own state hardware supply on the other. specifi c sanitation programmes: for example, Maharashtra and Bihar have their own state Designs of these programmes, their various level programmes as well. These are the Sant components and elements contained therein Gadge Baba Grameen Swachhata Abhiyan carry the inherent policy perspective. (SGBGSA) and Lohiya Swachhata Yojana (LSY) Information, education and communication respectively. While SGBGSA aims at creating (IEC), individual household latrines (IHHLs), clean villages through community action community sanitary complexes (CSCs), school following a spirit of competition, LSY intends sanitation and hygiene education (SSHE), to increase sanitation coverage by offering and rural sanitary marts and production monetary subsidy/incentives to APLs not centers (RSMs/PCs) are the key programme originally provided in TSC. Andhra Pradesh components. IEC is based on the policy and Himachal Pradesh have also their own assumption that awareness would generate state specifi c sanitation incentive programmes demand and demand would ensure safe and called Shubhram and MVSSP (Maharishi sustainable sanitation. Two more components Valmiki Sampoorna Swachchhata Puraskar) namely solid and liquid waste management respectively. and provision of revolving fund in the districts were included in the TSC Guidelines 2007. Assumptions that inhabit the programme TSC recognised that institutional toilets in design and its implementation strategy schools, anganwadis, and community facilities constitute the building blocks of various are important to make sanitation really total. programme components that address both It is acknowledged that mere coverage is not the supply and demand side of sanitation as enough, usage and behaviour change aspects a service. Subsidy for IHHL construction for

TSC: Coordinates of a Reform Initiative 19 BPL households suggests the policy position While IEC, HRD, and SSHE take care of the and the related assumption that the poor need demand side of sanitation, RSMs and PCs fi nancial help/incentive to construct toilets. are there to strengthen the supply side by SSHE positions school sanitation and hygiene matching the expected growth in demand for education as an integral component of a total sanitary hardware like bricks, cement, pans, sanitation initiative. squatting plates and P-traps.

20 Feeling the pulse 3. Key Findings

The study spanned many issues that included 2. A contentious policy issue has been one of coverage, quality of sanitation facilities subsidy or incentive to individual households created, usage, behavior change, inclusion, for construction of latrines. There has been equity, and gender relations. But the overall considerable amount of ambivalence in stated fi ndings from a national perspective of the policy position and prevalent practice on the programme are presented in four broad subsidy/incentive issue. categories of policy, strategy, institutional arrangements, and implementation practice. TSC Guidelines over the years and India’s As most of the issues are inter-connected, Country Papers presented in SACOSAN I (2003 they run through many of the study fi ndings in in Dhaka) and SACOSAN II (2006 in Islamabad) a fairly inclusive fashion. have consistently reiterated GoI’s commitment to the shift from a high to low to no subsidy approach. At the same time, the subsidy/ Policy incentive money for BPL households has been consistently on the rise: Rs. 500 during 1999- ‘…India will take the necessary steps 2004; Rs. 1,200 during 2005-2007; Rs. 2,200 towards formulation of a new National in 2008. The incentive money is reportedly Sanitation Policy.’ increased recently to Rs. 2,200 against the earlier Rs. 1200, though, offi cial confi rmation - India Country Paper titled ‘Total is still awaited. Sanitation and Hygiene: A challenge for India’ presented by Government of India at In two of the fi ve study states, namely Bihar SACOSAN I, Dhaka October 2003 and Chhattisgarh, state governments have made provisions for subsidy/incentive money Sanitation has been a matter of policy for above poverty line (APL) households concern for GoI since the fi rst fi ve year plan as well, besides providing additional in 1951. Sanitation being a state subject, incentive money to below poverty line (BPL GoI’s role, in initial three decades, that is households). Both these states are driven by between 1950-1970 was limited to making the dominant policy perspective that subsidy fi nancial provisions for construction of for hardware is one of the key drivers of the latrines in rural areas and urging state programme. However, actual results do not governments to take necessary steps to really ascertain the belief that subsidy works promote rural sanitation. and leads to the sanitation results that one wants. 1. Despite GoI’s stated intent to have a national sanitation policy, there has yet to The policy of providing additional subsidy, be a national policy on sanitation in India. even to APL households, such as in the However, GoI’s policy position on rural states of Bihar and Chhatisgarh seems to sanitation is enshrined in the principles and be based on this implicit assumption that approaches described in the TSC Guidelines. lack of sanitation in rural areas is largely due Most of the state governments also do not to people’s lack of resources to construct have a stated state policy on sanitation. None latrines, and hence they need to be fi nancially of the sample states visited had a state level supported to have one. Another related sanitation policy. assumption that seems to inform subsidy

Key Findings 21 policies is that once individual households Caste households expressed their reluctance have a latrine, all the members of the and resistance to use the toilets, as they found household would use it. them to be very badly constructed resulting in bad smell and mosquitoes. Though some 3. Technology has yet to be recognised as a women used these toilets some times, most major factor in safe sanitation at the policy of the men and children still went out for and programme implementation level. The defecation, as they found toilets to be dirty, idea is not only to have only sanitary latrines disgusting, and disagreeable. ‘Ghin lagati hai- at the individual household level, but to we fi nd it disgusting’ was the usual response have a safe pathogen free environment to of many a women, men, and children from ensure an improvement in the quality of life their communities. of people through signifi cant reduction in avoidable morbidity and mortality, specially infant and maternal mortality. While the stated Approaches and Strategies position on technology is one of promoting local innovations, in most of the states and Approaches and strategies to implement TSC districts, there is little effort on making this across districts and states vary with varying happen. results.

Single pit and off set latrines are being 1. The study indicates that a well thought out promoted with uniform hardware models and executed strategy has helped achieve in many districts. For example, in Bihar and faster and more sustainable results. Strategy Tripura, squatting plates being prepared by here is understood as an innovative plan Production Centers and line departments are of action especially designed to achieve being provided for latrine construction with the TSC objectives. In places like Sirsa little room for user preference. (Haryana), Sarguja (Chhattisgarh), and Shimoga (Karnataka), where there have been In many places in Haryana for example, people well articulated programme implementation carry this perception that smaller pits would strategies, results have been remarkable. fi ll up quickly and hence toilet pits should Common factors includes some kind of a be as wide and deep as possible. There is campaign mode focusing on people as the emerging evidence to suggest that deeper pits key actors and change agents in the process; are quite likely to cause faecal contamination involvement of school children and youth in of sub-surface water sources making things active planning and implementation; and, even worse in certain cases. This underscores daily monitoring of planned activities. the need to educate people and present to them a range of safe technology options for In most of the places TSC is being toilet construction as per local conditions and implemented in a routine administrative context. fashion without any conscious and visible attempt to strategise the implementation of 4. Quality of construction of toilets is emerging the programme. In states and districts where as one of the critical factors in ensuring usage there has been no clear strategy, there have and sustained behaviour change. In Vaishali been problems in translating the policy into district of Bihar, many members of Scheduled practice. In TSC, a variety of approaches and

22 Feeling the pulse strategies have been followed across different to state offi cials, the state would be able states and districts in India with varying to achieve MDG target related to sanitation degrees of successes and failures. by 2012.

2. Though TSC envisions a multi-stakeholder Programme functionaries attribute the involvement in the provision of sanitation as encouraging progress to the priority being a public good, there are noticeable variations accorded to rural sanitation by the state across states in terms of specifi c approaches, government now. The Chief Minister declared strategies and instruments used for its about two years ago that 10 lakh toilets would implementation. Examples from 5 study states be completed by December 2008 and an are as follows: amount of Rs. 50 crore was allocated in the The sanitation strategy in Bihar has current year for school sanitation. He himself been one of subsidy which is extended directly reviews progress every quarter since to APL households as well. Efforts at it is one of the 7 programmes on his review social mobilisation have been largely list. Besides, progress is regularly reviewed missing. The line department and its by the Chief Secretary, Secretary of PHED engineers have been made responsible and the Engineer-in-Chief. There has been for overseeing the implementation of TSC a general shift from involvement of NGOs on the ground. NGOs have been engaged to increased involvement of government primarily as construction contractors and functionaries and PRIs, particularly the their payment is linked to the number of Sarpanch and the Panchayat Secretary toilets constructed by them. The strategy at the Gram Panchayat (GP) level in the adopted has apparently not worked so implementation of the programme across well, as Bihar has the slowest rate of districts. sanitation coverage (currently at 22.56%) of the 5 sample states studied. Unfortunately though TSC has acquired In Chhattisgarh, TSC made slow progress a priority status both at political and in the fi rst 5 years (2001-2006), when administrative level it has become toilet coverage remained limited to 6% synonymous with NGP and the focus till the end of 2006. However, TSC has continues to be IHHL coverage. As a result, picked up since then and in the last one coercive rather than promotive methods are year i.e. 2007-2008, IHHL coverage went more in use at the Gram Panchayat level, up from 6% to 29%, which is a remarkable which raises questions about the sustained improvement on the past performance of use and maintenance of the toilets. the programme in the state. Around 8.5 Haryana has adopted the innovative lakh toilets have already been completed community centered approach widely and the state has won 12 and 90 awards known as Community-Led Total Sanitation under GoI’s post achievement award, the (CLTS) to scale up the TSC after the state Nirmal Gram Puraskar (NGP) in 2005 and government realised that progress was 2006 respectively. In 2007, 938 GPs and slow. ‘Sanitation has now become a silent 5 blocks have been nominated for NGP. revolution in the rural areas of the state’ As per the current growth rate under the (Urvashi Gulati, Financial Commissioner programme the state is one of the 5 better and Principal Secretary, Development and performing states in the country. According Panchayats, Government of Haryana). In a

Key Findings 23 matter of two years, progress has jumped follow as a result of emulations and peer from around 39% in 2005-06 to more pressure. than 70% in 2007-08. Whereas 60 GPs In Tripura, PRIs in general and GPs in received NGP during 2006-07, some 1,600 particular have been the key implementing GPs have been nominated in 2007-08 for agency for TSC on the ground. NGOs NGP awards. Sirsa district, with its 333 in certain cases have been involved to GPs, has declared itself to be totally open mobilise communities and educate them defection free. on the inter-linkages between sanitation, health and hygiene. The efforts started in 2006-07 with the capacity development on Community-Led Total It is thus obvious that the different states Sanitation (CLTS) with support from Water and have accorded different levels of priority to Sanitation Programme-South Asia to scale up the campaign and accordingly commensurate TSC in Haryana. This resulted in a signifi cant efforts to develop an effective policy, progress increase in the number of open defecation of TSC and coverage has been varied across free villages in the district. The trainings were the states. subsequently carried out in other districts as well in a demand responsive fashion. In Karnataka the adoption of a ‘campaign’ Institutional Arrangements approach has been effective. Intense, defi ned and planned activities have been TSC is being implemented as district projects undertaken over a limited period. There with funds directly fl owing to districts from is clarity about need to change mind set Government of India; state governments have and attitudes (‘transformation of a culture’ more of a supportive and facilitative role with according to EO, Thirthelli), which has led the added responsibility of contributing the to a focus on IEC rather than construction state share of the TSC district projects in time. of toilets. Conscious efforts have been made to reach a critical mass during the The generic institutional arrangement campaign period with an understanding termed as ‘delivery structure’ within the TSC that the remaining households would framework is given below:

24 Feeling the pulse Delivery Structure of Total Sanitation Campaign

Department of C Drinking Water Supply E Joint Secretary/ N Mission Director (R GNDWM) DDWS T Sanction of the Project, Center release of funds, Technical support, Placement of staff, M&E, Training and capacity building DS/Director E inter-sectoraal coordination (CRSO)

R

5 Technical S Programme System Analysts for Consultants Staff Monitoring and Section CRSP T Supported Software A by UNICEF Development by NIC T E

SWSM, PHED, PR & RD D State release of funds, technical support, development of state action plan, Inter-sectoral coordination with concerned Dept, Training and capacity I building, M&E S T R I NGOs for DWSM. ZP. DRDA C Baseline survery and development of action plan, Inter-secioral IEC, coordination with concerned Depts, Placement of the staff with T awareness defi ned role and responsibility, Training and capacity building, Overall implementation, M&E B L O C BDO, Engineers, Education and Health Offi cials RSM/PC for Institution building or activating exiting institution such as SMC, School NGOs for K Watsan/Health Committes, PTA and GP, Construction of the hardware production and facility, Mobilisation, Hygiene education activities, School health check-up IEC, sale of sanitary and regular de worming, monitoring, awareness V materials I L L GP, ANM, AWW, Motivator, VEC Institution building, Construction of the hardware facifi ty, Mobilisation, A Hyglene education activities, monitoring, O&M, Moniboing G E Source: ddws.nic.in

Key Findings 25 1. Though there is a broad delivery structure In districts where there has been a dedicated given for TSC implementation, there team of trained staff with their roles are variations across states in terms of and functions clearly defi ned and their actual institutional arrangement used for performance regularly monitored, results have programme implementation. For example been relatively much better than the cases in Karnataka, Karnataka Rural Water Supply where TSC has been implemented in a routine and Sanitation Agency (KRWSSA), set up administrative fashion. in early 90s to manage externally funded projects, has been the nodal agency for In several districts that include Sirsa programme implementation. In some (Haryana), Shimoga (Karnataka), and Sarguja states such as Bihar and Chhattisgarh, (Chhattisgarh), innovative institutional TSC is being implemented by Public Health mechanisms to implement and monitor TSC Engineering Departments. In Haryana, TSC have been put in place leading to much better is being implemented by the Department results than other districts such as Mewat of Panchayati Raj and Rural Development. (Haryana), Bidar (Karnataka), and Dhamtari In Tripura, responsibility for TSC (Chhattisgarh), where no such separate implementation has been transferred from attempt was made. Though in Dhamtari, a the Department of Rural Development to the TSC Cell has been created and a couple of Department of Drinking Water Supply and staff have been engaged, they are largely Sanitation. involved in providing secretarial support like preparation of reports etc, without any 2. The Communication and Capacity substantive engagement in programme Development Units (CCDUs) set up at the planning and implementation. state level by GoI are supposed to build required institutional and human capacities for effective implementation of TSC in states Implementation and districts, along with other national programmes. But CCDUs have yet to come 1. In TSC implementation on the ground the up as capable and reliable agencies for predominant focus has been on achieving building capacities required for effective TSC coverage measured by the number of IHHLs implementation in their respective states. constructed. Though being open defecation Interestingly, Haryana has done well without free (ODF) and fully sanitised is one of the a CCDU being in place, which has been qualifying criteria for NGP application, even in sanctioned by GoI recently and is yet to be the case of NGP villages, 100% toilet coverage established in the state. is deemed to be good enough for NGP application at the district level in most of the 3. Presence of a team of dedicated staff/ study states. volunteers and institutional mechanisms to manage and monitor their work on a regular In terms of sanitation coverage in India, basis has made things work in Haryana. available data suggest that to achieve Wherever staff with multiple responsibilities the objective of total coverage a total of such as in Bihar has been engaged in TSC 119 million IHHLs would be required to be work, progress has been relatively slow and constructed (some 59 million for BPL and results have been hard to come through. 60 million for APL households) out of which

26 Feeling the pulse 48 million have been already constructed. of toilets to be constructed in the sample TSC was initiated in Tripura and Karnataka in sates varies considerably with population. 2002-2003, while in remaining study states it For example in Bihar the number of toilets was initiated in year 2003-2004. Chhattisgarh to be constructed under the TSC programme has taken a leap in progress in 2006-07. In is close to around 112 lakh while that for terms of percentage, overall progress in IHHL Chhattisgarh it is 33.6 lakh; Haryana it is 17.8 has been 40%, around 45% for BPL and 35% lakh; Karnataka -54.2 lakh and Tripura is close for APL families. Haryana (78%) and Tripura to 6 lakh. (91%) have reported higher percentage achievements as against targets as suggested 2. In terms of allocation and use of funds, the in the Graph 1 below. available fi gures suggest that GoI has released only 38% of the approved outlay till October While drawing conclusions on the coverage 2008 against which 29% expenditure has been one should bear in mind that the total number reported. Out of the study states, Tripura and

Graph 1: IHHL coverage in states of the current TSC study

Status of IHHL coverage in Study States

All India

Tripura

Karnataka

Haryana

Chattisgarh State

Bihar

0% 20% 40% 60% 80% 100%

Bihar Chattisgarh Haryana Karnataka Tripura All India

TOTAL 10% 28% 78% 29% 91% 40%

APL 5% 23% 77% 27% 88% 35%

BPL 14% 34% 80% 33% 92% 45%

Percent Achieved

Key Findings 27 Haryana have been the leading states, which 3. TSC has picked up since 2005-2006. Though have secured 80% and 66% respectively of the the programme was launched in 1999-2000, GoI’s share and reported expenditure of 60% progress during fi rst fi ve years was slow and 52% against such release. While Bihar with an average annual growth rate of 7.14% and Karnataka with 24% and 27 % of Central in sanitation coverage. The growth rate in release respectively are at the lower end, sanitation coverage has picked up in many Chhattisgarh has managed to secure 43% of states since 2005-2006 resulting in average the GoI share. The country level data suggest annual growth rate of 20.21%. This has been that states have cumulatively released a 13.06% increase in the overall annual 62% of the approved outlay against which growth rate at the country level. The same has expenditure up to 44% has been reported as been true for the 5 study states whose IHHL indicated in Graph 2. coverage status is given in Graph 3.

Graph 2: Financial progress against approved share in states of the current TSC study

Financial Progress a against approved share - Releases vs. Expenditure Reported

Benef

State

Expenditure Reported Centre Share Benef

State Released Share Centre

0% 20% 40% 60% 80% 100% 120% 140% 160%

Released Share Expenditure Reported Centre State Benef Centre State Benef

All India 38% 62% 57% 29% 44% 37%

Tripura 80% 76% 110% 60% 71% 74%

Karnataka 27% 47% 110% 24% 36% 27% Haryana 66% 101% 152% 52% 59% 57%

Chattisgarh 43% 83% 23% 33% 52% 18% Bihar 24% 31% 7% 15% 13% 6%

Percentage

Note: Benef: Benefi ciaries

28 Feeling the pulse Graph 3: Year-wise coverage of IHHL in states of the current TSC study

Year-wise coverage of IHHL in Study states

500000

450000

400000

350000

300000

250000

Coverage (nos.) 200000

150000

100000

50000

0 2001-2002 2002-2003 2003-2004 2004-2005 2005-2006 2006-2007

Bihar 0 0 32973 55088 58583 168566

Chattisgarh 0 0 892 4354 23832 288953

Haryana 0 99 40956 56889 142163 326403

Karnataka 0 13707 17754 3450 212941 449196

Tripura 0 33826 246412 51380 101983 20347

years

However, within states there have been in Bihar, Chhattisgarh, and Karnataka, in variations across districts in terms of order to take care of the situation during GoI sanitation coverage, usage and behavior verifi cation of NGP applicant GPs, general change, as revealed during the study. cleanliness of village has been ensured by GPs one time, without any system to sustain it on a 4. As against the stated policy position of TSC continuing basis. being community led and people centered, the actual implementation of the programme The concept of total sanitation in TSC, besides in most of the districts and states focuses on IHHLs, also entails components of solid and construction of individual household latrines liquid waste management, hygiene education, (IHHLs). and school and anganwadi sanitation. While there has been a visible change in the school 5. Other components of TSC such as solid and anganwadi sanitation scenario across and liquid waste management and hygiene all the study districts, hygiene education education have been largely neglected in and solid and liquid waste management are actual programme implementation on the largely ignored in most of these places in TSC ground. As fi eld visits indicate, in many cases implementation.

Key Findings 29 6. In some places, convergence with on- subsidy; these places include Sirsa, Sarguja going programmes in other sectors such and Shimoga. as ICDS and health has been successfully tried out to deepen the implementation 8. A target driven approach to getting as many and impact of total sanitation outcomes. NGP nominations and awards as possible However, monitoring of hygiene behaviour at the state and district level could prove change among children was found to detrimental. As NGP awards are mainly being be carried out only in Sarguja district of given to GPs, it has emerged as a matter Chhattisgarh. of status for GPs in general and concerned pradhans/sarpanches in particular. This Another related implementation issue is has resulted in a desperate rush to secure one of inter-departmental coordination, the NGP status for the GP rather than in a which has been tried out in some states that community initiative to get the GP really include Bihar, Chhattisgarh, and Karnataka; open defecation free and fully sanitised. The this has been really possible and effective number of practices characterising this rush where there have been local champions with include construction of inappropriate and keen interest in the implementation of the unsafe IHHLs, school toilets and community programme. complexes without any creation of genuine demand or involvement of community 7. There is clear evidence emerging from members; usage and behaviour change the sample studied that places where faster aspects of sanitation being totally ignored results have been achieved, there has and manipulated during presentation to the been greater mass mobilisation with rural visiting verifi cation teams and people being communities involved into participatory pressurised or threatened to construct IHHLs analysis and action without any allurement of within tight time schedules.

30 Feeling the pulse 4. Subsidy and Incentive: Perceptions and Realities

‘Subsidy for individual household latrine units has been replaced by incentive to the poorest of the poor households… The programme is aimed to cover all the rural families. Incentive as provided under the scheme may be provided to Below Poverty Line (BPL) families, if the same is considered necessary for full involvement of the community…’ - TSC Guidelines Jan 2004/Dec 2007

Traditionally subsidy has been central to availability of sanitary latrine at the household sanitation initiatives in India. Idea of social level would entail its usage and the resultant mobilisation for sanitation is relatively health benefi ts. It took more than a decade to new. TSC, the GoI’s reform initiative in realise that the assumption did not really work sanitation, has subsidy/incentive to individual out in reality. Hence, TSC represented a shift households as one of its defi ning features, from a high to low and no subsidy regime in and intends the campaign to be ‘community provision of sanitation services. led’ and ‘people centered’, which invariably require social mobilisation efforts. Study states of Bihar and Chhattisgarh, where state governments have made TSC Guidelines 2004 and 2007 do not provisions for subsidy/incentive money for use the term subsidy and funds given for above poverty line (APL) households as well, construction of individual household latrine seem to be driven by the dominant policy is called incentive, which is available only perspective that subsidy for hardware is for BPL households. There is no provision one of the key drivers of the programme. of any incentive money for APL households However, actual results do not really under TSC. warrant the belief that subsidy works and leads to the desired sanitation Before TSC, subsidy for hardware was the core outcomes. of sanitation programmes in India in general and Central Rural Sanitation Programme TSC Guidelines prescribe an incentive (CRSP) in particular. Though not stated, structure for two models as given in Table 1 the inherent assumption seemed to be that below:

Table 1: Incentive structure for various low cost toilet models

Basic Low cost Unit Contribution Percentage Cost GoI % State% HH% APL BPL APL BPL APL BPL Model 1: up to Rs. 1,500 Nil 60 NIL 20 100 20 (Including Superstructure) Model 2: Between Rs. 1,500/- Nil 30 Nil 30 100 40 and Rs. 2,000/- Above Rs. 2,000/- Nil Nil Nil Nil 100 100

Subsidy and Incentive: Perceptions and Realities 31 1. The TSC Guidelines do not defi ne the models & II respectively), from its own funds. The in terms of technology, which means there is governments of Chhattisgarh and Bihar fl exibility in adoption of technology. As per the have provided higher amounts of subsidy/ Guidelines, the incentive given by the Central incentive from their own budgets under their Government will continue to be admissible respective state incentive schemes as given with reference to the cost of the basic low cost in Table 2. These include additional subsidy unit as given in the above Table and in no case to the BPL families and to APL households will the overall quantum of Central incentive as well. Tripura, Karnataka and Haryana exceed the admissible amount. are making their minimum contributions as expected by GoI guidelines. However, The TSC Guidelines do not prescribe any Haryana has downplayed subsidy/incentive incentive when the unit cost of the model components in actual delivery of the is beyond Rs. 2,000. The central incentive programme. scheme does not offer incentive to the APL households under the assumption that these 3. Though the Guidelines prescribe the take up construction of the latrines on their incentives as a percentage of the cost of the own. unit, it is silent on the process/responsibility for estimating the cost of the low cost unit 2. The Guidelines allow liberty to the state on which the incentive is to be provided. governments to provide for more incentive It is assumed that the state/district would for household toilet than the minimum estimate the cost of each of the IHHL so amounts of Rs. 300 and Rs. 600 for toilets constructed for the purpose of release of the costing Rs. 1,500 and Rs. 2,000 (Models I incentive.

Table 2: Incentive structures in Bihar and Chhattisgarh

Sl No BPL APL Centre State Household Centre State Household Contributions (in Rs.) as per GoI guidelines IHHL Unit cost 900 300 300 - - 1,500 Rs. 1,500 IHHL Unit cost 600 600 800 2,000 Rs. 2,000 Contributions (in Rs.) as prevalent in states Bihar – Lohiya Swachhata Yojana IHHL Unit cost 600 1,100 300 - 1,500 500 Rs. 2,000 Chhattisgarh IHHL Unit cost 900 300 + 1,000 for 300 - 900+ 1,000 for 600 Rs. 1,500 superstructure superstructure Haryana Same as provided in GoI guidelines Tripura Same as provided in GoI guidelines Karnataka Same as provided in GoI guidelines

32 Feeling the pulse 4. The stated policy position of TSC is that a conscious downplay of the subsidy/ sanitation, in order to be really sustainable, incentive provided within TSC. All the CLTS has to be community led and people centered facilitators in the district were therefore and the guidelines seem to carry an inherent trained to engage communities in analysis unstated recognition that sanitation is and action without mentioning any kind essentially a public good and that its provision of monetary support at any stage in the can be effectively ensured through collective process of mobilising communities for efforts of rural communities. Unfortunately, sanitation. The option of using the individual this doesn’t really show through in actual subsidy/incentive money for providing practice on the ground. community incentive to ODF GPs is being actively considered is pending approval with Interactions with stakeholders across 5 states the GoI. and 10 districts in India, particularly policy makers and programme managers, revealed Available data as indicated in Table 1 in that there are two broad approaches of the previous chapter clearly suggests looking at the subsidy issue: that high subsidy has not worked at all in a. The dominant approach is the one that the case of TSC: states such as Bihar and considers subsidy to be essential for the Chhattisgarh even with a high subsidy success of TSC. In Bihar, Chhattisgarh, regime have the current coverage of IHHLs Karnataka, and Tripura, there were not only at 22.17% and 32.63% respectively, only strong supporters of a subsidy which is lower than the country average regime, but also those who argued of 55.69%1 and much lower than Haryana, in favour of increasing the subsidy which has the current coverage at more amount, which they found to be highly than 70%. However, it is important to note inadequate for latrine construction in here that comparison in terms of coverage, view of the increased cost of required though fairly indicative, may conceal major hardware for the purpose. differences in terms of absolute number of Subsidy approach to sanitation looks people covered. at sanitation primarily as a matter of latrine/toilet construction and hence as 5. The key issues in subsidy are as follows: a private good. Whether subsidy works in promoting b. Another fast emerging approach with sanitation in rural communities few followers, but staunch supporters, including the desired behaviour is one of no subsidy. changes? If subsidy works, how does it work No-subsidy approach considers subsidy and in what ways to get what specifi c to be detrimental to community processes results? and hence as a hindrance to total If subsidy has to be given, what should sanitation. This approach views sanitation be the appropriate amount and how primarily as a community issue and a can it be arrived at? public good.

1 Percentages in the paragraph are worked out on the In Haryana, where CLTS approach has basis of data available on GoI’s website ddws.govt. been successfully used there has been in as on 30 September 2008.

Subsidy and Incentive: Perceptions and Realities 33 Response to these questions is generally - India Country Paper titled determined by assumptions rather a reality ‘Total Sanitation and Hygiene: A check in implementation practice. What challenge for India’ presented by appears to be the consistent policy position at Government of India at SACOSAN I, the GoI, not really matched by practice in all Dhaka October 2003 the states, is the availability of incentive only b. ‘While the low-to no subsidy regime for the poorest of the poor. may be acceptable as a long term policy goal, in order to achieve the objective The following excerpts are relevant in this of full coverage of rural households regard. through appropriate sanitation systems, a. ‘Low to no subsidy: One of the key providing fi nancial incentives to BPL aspects of the reform agenda was households will have to be continued reduction of central and state subsidy as a strategy. The quantum of subsidy levels from as high as Rs. 2,000 to as well as unit costs need to be revised household toilets to Rs. 500 for rural suitably and made area specifi c rather households below the poverty line than uniform all across the country, and zero subsidies to those above the through a realistic assessment of poverty line. Even among the poor the material and construction costs, subsidy was reduced for people opting availability of material and practicability. for high cost technology options. People are willing to pay for sanitation This met with initial skepticism and this needs to constitute the major and resistance from many but over strength of the programme.’ a period of time the rationale has - Mid term evaluation of TSC programme been realised by majority of states by Agriculture Finance Corporation, and country is fast moving in this Northern Regional Offi ce, New Delhi, direction.’ March 2005

34 Feeling the pulse 5. IEC and Behaviour Change

“Information, education and communication (IEC) is one of the key programme components of TSC. It is envisaged to create awareness and generate demand…” - TSC guidelines, Dec 2007

Under IEC a wide variety of messages and 2. Written messages in posters, pamphlets, communication tools and techniques have and wall writings have largely not made any been used to create awareness at the visible impact, as few of the respondents community level across different states and admitted these messages as the source of districts. The communication techniques inspiration for adoption of sanitary practices. used include folk theatre, radio, TV, and Inquiry revealed that most of these messages communication campaigns involving have been designed without any audience posters, pamphlets, wall writings, etc. In analysis or/and communication needs some places social mobilisation efforts assessment in most of the districts and states. have been made using PRA and CLTS However, messages highlighting damage to techniques through trained community family honour due to adolescent girls and facilitators. women defecating in the open have worked in terms of hitting at the self-esteem of men during one to one individual and group interactions in places with strong patriarchal societies such as in Haryana.

Slogan painted on wall in Kailashahar, Tripura

1. Inter-personal communication involving persuasive dialogues and discussions with Wall painting in Chhattisgarh individual members of the household during door-to-door visits has been the most effective 3. The key message of public health communication tool within the IEC framework. impact of sanitation is largely subsumed. It has worked particularly well in cases This has sometimes led to toilets getting where due to some resistant households, constructed and even used by those who communities have been facing diffi culties need them, but does not necessarily result in achieving full sanitation coverage in their in instilling sustained behavior change by villages. There are instances of this working all the members of the community, which is both from Chhattisgarh and Haryana. critical to achieve public health outcomes,

IEC and Behaviour Change 35 which remain the fundamental objective of interpersonal communication and the use improved sanitation. of mass communication for reinforcement of messages after triggering community for 4. There has been little evidence to show collective behaviour change has yielded that conventional one time standalone IEC results. These included mass media campaign methods, used in most of the states have through print and visual mode, Swachhata actually mobilised communities into self- Rath, exposure tours, Swachhata Saptah in analysis and action on their own, as was addition to the conventional tools such as found in the case of PRA and CLTS methods in posters, wall writings etc. The innovative Haryana and Chhattisgarh1. feature of Haryana type IEC is that the traditional tools of IEC have been used as 5. The content and delivery modes of IEC reinforcement measures rather than stand messages has, in some cases, resulted in alone activities as has been the case in some the construction of unsafe toilets, which other states. can lead to contamination of water bodies. Gaps in awareness about technology options In order to negate the adverse and related engineering aspects, hardware consequences of poor sanitation and maintenance issues, handwashing and to secure the benefits envisaged from hygiene awareness both at school and improved sanitation, it is important to community level, also raise question about ensure collective action motivated primarily the effi cacy of the content and delivery of IEC by the need to change behaviour. Behaviour adopted in almost all the states visited. change can only be sustained if collective action is the result of self-realisation by the 6. Haryana has successfully used a mix of community of the adverse consequences CLTS and Gandhian technique of winning of prevailing defecation practices. Igniting over the wrong doer through compassion. self-realisation in the community about the In Sirsa, wherein the focus has been on negative effects of open defecation along with the adoption of improved and hygienic practices that ensure a safe, sanitary, and 1 However, in cases where literacy rates have been high such as in Shimoga in Karnataka, IEC seem to open defecation-free environment is another have worked to some extent in terms of creating critical element generally lacking in the IEC necessary awareness and action at the local level. approaches.

36 Feeling the pulse 6. Inclusion, Equity and Gender Relations

‘Separate toilets for girls and boys should be provided in all co-educational schools…School toilet designs should…comply with benchmarks set for “ child friendliness” and “Gender responsiveness” and to provide access opportunities to children with special needs…’ - TSC Guidelines, Dec 2007

The fi rst stated objective of TSC is to ‘bring implementation plans and strategies of most about an improvement in the general quality of the states and districts. of life in the rural areas’. As sanitation is essentially about people’s lives, their health and well being, it obviously involves Women men, women, children, old, sick and the challenged, who carry differential needs Women are the major stakeholders in and interests. Lack of sustained access to sanitation initiatives, as their lives and the safe sanitation has a bearing on avoidable lives of their family members get critically morbidity and mortality, particularly infant affected by the adverse consequences of poor mortality. The stated strategy of TSC and unsafe sanitation. There is overwhelming ‘addresses all sections of rural population evidence to the effect that women in rural to bring about the relevant behavioural areas have to suffer the most due to lack changes for improved sanitation and of sanitation facilities at home; as a result hygiene practices and meet their sanitary they have to walk long distances in the dark hardware requirements in an affordable before dawn and after dusk in search of place and accessible manner by offering a wide for defecation in the open. This practice has range of technological options’. Within the serious implications for their health and TSC programme framework, concerns for well being. They lose out on their privacy, inclusion, equity and gender relations are productivity, and dignity and run the risk of not clearly articulated. As a result, even at even rape and molestation. the state level, there has been no conscious attempt or strategy to address these issues One major issue that the guidelines fail to in an integrated and inclusive fashion. address is that of menstrual hygiene. Given that 50 per cent of the population comprises Sanitation is ‘life with dignity’ and hence of women and that menstrual hygiene is directly linked to issues of inclusion, equity, critical for the health of women over a large and gender relations. The poor are often are span of their lives, this omission needs to be excluded and marginalised having limited urgently addressed. or no access to essential services including water and sanitation. Tribals and women are In places where women have been included as two distinctive categories of people, who key actors and community sanitation activists, have been culturally and socially excluded results have been signifi cant. In Haryana for and marginalised in a number of ways. Hence, instance, women have played a very important involving them as active participants and role in securing safe defecation practices change agents in the development processes, across several districts. Adolescent girls along as also in service provision, requires special with elderly ladies have joined the overall efforts, which have been largely missing from effort by participating in the various vigilance

Inclusion, Equity and Gender relations 37 committees, to dissuade the community from communities have worked out their own ways defecating in the open. Women SHGs have and mechanisms to cross subsidise the poor come forward to support construction of for construction of their sanitation facilities. individual household toilets fi nancially and has contributed signifi cantly to collective But at the same time there is a strong argument local action in many parts of Karnataka, in favour of providing fi nancial help to the Chhattisgarh and Haryana. In Haryana there is poor, especially the poorest of the poor. In the a visible attempt to ensure better menstrual villages visited in Vaishali and Nalanda districts hygiene and management by provision of of Bihar, a large number of poor households sanitary napkins to women in rural areas had no knowledge about the sanitation through women SHGs. programme in the village, which included an NGP awarded village, where some 500 people from 45 households of a Majhi Tola (dalit Poor locality of ‘musahars’ translated as rat-eaters) were provided with a community toilet complex, The sanitation needs of the poor in general and which they never used. It is not surprising as the poorest of the poor in particular have been these people were since it was near religious the biggest challenge in TSC implementation place never involved in any analysis, decision on the ground. TSC Guidelines (2007) propose and action regarding sanitation in the village. monetary incentive only for the poorest of the poor, which is the only given programme This instance and many similar instances instrument to include them in sanitation underline the need to include the poor, the campaign as participants. But entry of poor tribals, the women and the marginalised in in rural sanitation initiative as recipients of community processes as active agents of incentive positions them as benefi ciaries change. It is important to engage them as divesting them of their agency as sanitation stakeholders and not as mere benefi ciaries in activists and change agents in a process of the process. collective local action as equal participants.

There are instances from many districts Tribals and states where triggered and mobilised Of the 5 study states, Chhattisgarh and Tripura are the two states with a fairly sizable population (as described in respective state reports later) of tribal communities. However, tribals in these states represent quite contrasting attitude and behaviour regarding sanitation.

Whereas in Chhattisgarh, general cleanliness and hygiene levels are fairly well advanced in tribal communities, which have emerged as sanitation leaders in their respective areas, in tribal areas of North Tripura and Dhalai Latrine in Dalit household in Nalanda districts of Tripura, getting tribal people to

38 Feeling the pulse Toilets of tribals in Sarguja and Dhamtari districts in Chhattisgarh Tribal villages in Sarguja district of Chhattisgarh are clean. Traditionally, they keep their houses painted with mud and use colours to decorate them. Safe water handling practices are adopted. Regarding the superstructure of toilets, villagers were encouraged by programme functionaries to build their toilets like their houses with no monetary support from outside. Thus the tribals had an opportunity to use their creativity in designing the superstructure of their toilets. Involvement (both physical and fi nancial) of households in the design and construction of superstructure has ensured that their preferences are taken into account. As a result, the super structure of toilets is like any other room in the house spacious and well ventilated. Wild animals are painted on the toilet walls in spirit with the tribals’ close association with nature. On the other hand, in tribal village Chinwarri, of Nagri block, Dhamtari district, Chhattisgarh, temporary superstructures made of bamboo and polythene sheets, as provided by GP, were found to be broken and in disuse. In some cases, some of the members (particularly young women) Anganwadi Toilet in Sarguja were using the toilets more often, while others were using it selectively during nights. Most of the people in the village were of the view that the temporary structures are not good and the panchayat should have built pucca superstructure rather than providing polythene sheets. An old woman remarked ‘Hamar man ke nahin kare han. Mola koi fayada nahin lagat hai.’ (They have not done it as per our expectations. I do not see any benefi t in it). Similarly, a young man in his 30 named Prabhu, whose house was adjacent to the school, admitted that he was going out in the open for defecation. The thatched superstructure of his toilet was broken and the pan was dirty and gave an impression that it was not being used for quite sometime. Almost all the toilets in the village did not have roofs. make a shift from open defecation to safe happen, he highlighted the critical signifi cance fi xed point defecation has been diffi cult to of educating children in sanitation and hygiene come through. In Tripura, tribal households practices, which has the potential to bring are the only ones practicing open defecation about fundamental social transformation. currently, as all others, have been practicing fi xed point defecation, though not always Within the TSC programme design and delivery safe, for as long as they can remember. framework, there is no conscious attempt to engage with tribals, as marginalised and DC, Dhalai, who himself is from a tribal excluded communities. It is probably implicitly community in the same district during the assumed that community involvement study visit, said that ‘sanitation behaviour approach would end up including the tribals change is a matter of habit and culture, and not as well, which may or may not be the case of money or technology’. In order to make this depending on the local context.

Inclusion, Equity and Gender relations 39 7. Technology and Safe Sanitation

One of the key objectives of the TSC is to ‘encourage cost effective and appropriate technologies for ecologically safe and sustainable sanitation’ - TSC Guidelines 2007

Earlier sanitation hinged around technology, be an expensive proposition costing anything as it focused on construction and construction between Rs. 5,000-50,000. Another prevalent meant primacy of technology. But the myth is about the size of the pit to be dug paradigm shift, represented by TSC, positions for a long lasting latrine. Like for instance, in sanitation primarily as a people’s issue. As the Haryana, people think that pits should be as ultimate objective of the reform programme wide and deep as possible to prevent it from in sanitation is to improve the quality of life fi lling up quickly, and to offset the need to of people in the rural areas of the country, clean it up in their life times. There is hardly any technology needs to be addressed as a substantive attempt to dispel these myths by concern for safe sanitation, and not as an undertaking appropriate IEC activities to create issue of engineering excellence. the required awareness among the potential user communities. Safe sanitation systems need to include two essential components: one, change of 2. In many places, non-involvement of people behaviour arising out of shifts in attitude and in the design and execution of projects perception; two, cost effective, eco friendly has led to incomplete construction, sub- and appropriate technology choices. standard quality of materials being used, poor workmanship and inadequate and 1. In order to be safe and sustainable, inappropriate maintenance. In most of the selection of sanitation technology has to states visited, there is no visible attempt to be based on an informed understanding of promote an informed choice of technology local terrain, soil quality, precipitation levels, option by people. In few cases, though the water table and weather conditions. There efforts have been made at the macro level, is a growing realisation in the sector that the same has not percolated down to the users should be able to choose from a range village/community level. Perhaps this may of options or steps in latrine technology as be because the GoI subsidy or incentive is part of a promotion strategy, in contrast to a based on only two models (basic unit with uniform model. This implies the possibility for superstructure), up to Rs. 1,500 and between incremental improvements, moving ‘up the Rs. 1,500-2,000. In most of the cases the steps of the sanitation ladder’ driven by local latrine designs have been prescribed by the needs, capacities and innovations. implementing agencies without leaving much scope for local innovations. Though there Study fi ndings suggest popular myths around have been some attempts to use different pit technology based on people’s lack of awareness linings with local materials (Shimoga district, about technology aspects and their implications Karnataka, Sarguja district, Chhattisgarh) to for safe sanitation. One of the most widespread reduce the cost, these instances are limited to myths is around the cost of the technology few pockets only. In some districts of Tripura, itself. In most of the districts and states visited, no honey combing or pit lining is provided due people in general believe latrine construction to to escalated cost of the material.

40 Feeling the pulse 3. Wherever there is an attempt to innovate 4. Quality of construction of toilets is designs involving the community members emerging as one of the critical factors vis-à- and in view of their specifi c preferences, it vis usage and sustained behavior change. has brought good results. For example, in But for a few exceptions, the quality of Sarguja district of Chhattisgarh involvement of construction in general is neglected and households in the design and construction of toilets are constructed apparently to meet superstructure has been ensured so that their targets by erecting structures. Many of the preferences are taken into account. The super installations are in an unfi nished state and structure of toilets here in general is more without superstructure, exposing the people user friendly and acceptable, as it is designed to public gaze with no privacy or dignity. One by people themselves keeping in view their of the probable reasons is poor facilitation traditional housing practices and preferences of community processes and the resultant involving features such as suffi cient space lack of community capacity and motivation to and provision for cross ventilation. As a undertake sanitation in the right earnest. contrast in Dhamtari district of the same state where the designs have been prescribed by In Vaishali district of Bihar, where NGOs have the implementing agencies the quality of been engaged to carry out the responsibility construction is not up to the mark, with torn of construction, many members of Scheduled and mutilated superstructures and unused Caste households expressed their reluctance substructures. or/and resistance to use the toilets, as they found them to be badly constructed resulting In Shimoga and Bidar districts of Karnataka in foul odour and mosquitoes. Though some many latrines lacked junction chambers and women used these toilets some times, most the owner lacked awareness about emptying of the men and children still went out for pits. Numerous latrine structures have been defecation, as they found toilets to be dirty, erected with temporary superstructures. An disgusting, and disagreeable. ‘Ghin lagti hai- incomplete structure because of shortage of we fi nd it disgusting’ was the usual response funds with households is also a fairly common of many a women, men, and children from sight in many of these places. dalit communities.

Toilet construction and water quality In Rani Sarai village of Ghosra wana GP, Giriyak block, Nalanda district in Bihar, most toilets in the village were found to be closed (5-10 feet from the toilet pit) to the shallow hand pumps that were being used for drinking water. This poses a serious problem of groundwater contamination in the long run. When the issue was discussed at the district level, Madan Mohan Kumar, Executive Engineer, Nalanda said that it was not a problem. However, one NGO functionary present there mentioned it as a potential threat. Another NGO functionary was of the view that a sand cushion around the pit could solve this problem. On sharing the attendant risk of water contamination of ground water in case of leach pit toilets being constructed close to hand pumps, the Secretary, PHED, acknowledged the risk being there, but maintained that it is bound to happen because of non-availability of space with the poor households.

Technology and Safe Sanitation 41 5. In some states, designs which by-pass Similarly in Tripura traditionally deeper pits standard norms of technology safeguards (more than 10 ft) without safe linings have and have the potential of contaminating been used and in many cases the same has ground water have been adopted under the been adopted under TSC also. People in this programme. In Sirsa district of Haryana, region also feel that smaller pits would fi ll traditionally deep dry pit toilets are used. up quickly. The state government reportedly These toilets (known as ‘kui’ or ‘Dhamaka’ in has been alarmed about the vulnerability of the area) are usually around two and a half groundwater to contamination due to these feet wide and some 20-40 feet deep. There pits. Furthermore, with the growing thrust is a general apprehension in the district that on the squatting plate with water seal and smaller size pits would get fi lled up early. P-trap, the larger community has started These pits contain no safety lining and there using it after removing the P-trap and making are instances of these collapsing or caving in. it similar to the traditional toilets. This is a The district team apparently responsible for common behaviour across the state of Tripura generating demand have by-passed the need and reportedly is a result of a strong belief to promote safe technology measures during among community to avoid looking at one’s the campaign period. own faeces.

6. Results of training of masons for improving Unaware about technology options construction quality is dependent on their engagement. In Bihar, where more than A toilet, which was under construction in 4,000 masons have been trained so far, a Parmila’s house in village Pilkhi, Block Rajgir, District Nalanda in Bihar, is a costly on pit visible impact on the ground in terms of toilet. The household has spent more than Rs. improved quality of construction is yet to be 5,000 and the toilet is yet to be completed. seen. This seems to be due to an apparent The household had no idea about off set pits lack of mechanism to engage them in toilet and other technology choices otherwise, as construction. As a contrast, in Sarguja district stated by Pramila, they would have gone for of Chhattisgarh the attempt to train local better options keeping in view the kind of masons in toilet technology has brought investment they wanted to make. Parmila shared a case of Mithlesh who had constructed a septic tank toilet in her house, whose tank was wrongly constructed and it was leaking. This foul water of the toilet was passing through the street that used to stink and therefore often there was a quarrel with neighbours. Finally, her mother-in-law asked her to go for open defecation and stop using the toilet. Lack of awareness about available technology options has resulted in excess expenditure and reversal to the practice of open defecation. Toilet in a tribal village of Sarguja

42 Feeling the pulse encouraging results in terms of good quality of construction of IHHLs. In this case, it seems to have worked as this has been supplemented by dedicated supervision of construction and its quality by the PHED engineers.

7. There is apparently little thrust on promoting technology options for solid and liquid waste management. Barring a few cases in Chhattisgarh and Haryana compost pits were rare. Traditional disposal methods of emptying the solid waste outside the house Pans piled up in Vaishali district for distribution compound in open space or street appears to be a common practice. However, there have been sporadic cases of use of waste bins and Also there is a need for encouraging local emptying in paddy fi elds with no large scale technological innovation to convert existing community level behaviour change. Disposal unhygienic latrine such as Dhamaka/Kui of liquid waste in open space or in unused latrine in Haryana and deep pit latrine in water body is the most common practice used Tripura into safe and hygienic options. by households with few cases of soak pits and community drainage. Proper drainage, 9. The importance of supply chain mechanism and solid and liquid waste management are is vital to the success of the sanitation largely ignored in most of these places in TSC programme. Quality and skills for construction implementation. are essential at all outreach locations (RSMs and PCs) and needs to be integrated in the 8. Maintenance of the facilities also is an communication/IEC plans. emerging concern in the light of lack of understanding about the intricacies of 10. Ecosan has been conspicuous by its adopted technology options. For example, absence in all the study states. Ecosan with its in some regions (Karnataka) there was clear focus on treating human waste as a resource lack of information about the utility of second to be used in an eco-friendly manner holds pit, the emptying of pits, the use of junction a lot of promise for safe and sustainable chamber, etc. There is an urgent need to environmental sanitation and could be build in technology concerns and related promoted as one of the options in the process information in the IEC messages to ensure of presenting technology options to people sustained usage and to arrest slippages. under TSC.

Technology and Safe Sanitation 43 8. Nirmal Gram Puraskar (NGP)

‘To add vigour to TSC implementation, Government of India has separately launched an award scheme called the “Nirmal Gram Puraskar” for fully sanitised and open defecation free Gram Panchayats, Blocks and Districts…’ - TSC Guidelines Jan 2004

Nirmal Gram Puraskar (NGP-Clean Village For NGP application, eligible village Award) was instituted by the Government panchayats, blocks, and districts are those of India on 2nd October 2003 to recognise, that achieve (a) 100% sanitation coverage encourage and facilitate PRIs and those of individual households, (b) 100% school individuals and organisations that work sanitation coverage, and are (c) free with them to achieve total sanitation. Using from open defecation and (d) maintain outcome based fi nancial incentives in the form environmental cleanliness. Also eligible of NGP to promote sanitation and hygiene for the award are individuals and behaviour changes in rural communities has organisations, which have been the been an innovative programme implementation driving force for effecting full sanitation strategy. This model has demonstrated how coverage in their respective geographical an incentive strategy can motivate the PRIs areas. in taking up sanitation promotion activities by shifting their priorities from hardware to The rapid annual rise in NGP villages is given behaviour change aspects of sanitation. in Graph 1 below.

Graph 1: Number of NGP villages from 2005-2008

Number of NGP awards

12000 10094 10000 8000 NGP awards 6000 4959 4000 2000 709 41 0 2005 2006 2007 2008

Source: DDWS website

44 Feeling the pulse 1. NGP has succeeded in introducing a healthy two practices observed in the states of Bihar, competition among GPs and has imparted Haryana and Karnataka: (i) the programme a visible momentum to the TSC programme itself is popularly referred to as NGP rather since its introduction in 2003-04. As is evident than TSC (Bihar); and (ii) there is a tendency from the above graph the number of NGPs for districts to identify potential NGP GPs (soft is growing each year since 2005. The award targets) and focus on them in their annual has been instrumental not only in increasing plan (Haryana and Karnataka). the sanitation coverage at greater speed, but has also helped in drawing attention to the 3. Rates of reduction of NGP applications is crucial signifi cance of ‘ODF and fully sanitised high. Only a few GPs out of the total number of status’ of rural communities as a matter of applicants are getting selected for nomination public good. The pride and honour associated into NGP, as suggested in Graph 2. with receiving an award from the President of India has been extremely attractive for elected The rejection rate has been 69.71, 75.93, heads of GPs to take a personal interest in 50.24, 29.96, and 83.24% for Bihar, TSC covering all households and schools with Chhattisgarh, Haryana, Karnataka and sanitation facilities as well as solid and liquid Tripura respectively. These alarming rates waste management in villages. This year more of rejection indicate either there is a total than 30,000 nominations have been received. absence of a proper system of monitoring at the district/State level while selecting the GPs 2. However there is a fl ip side to the NGP for nomination into NGP or the effi cacy of such story that requires attention and intervention. system (if any) is debatable. GoI has been During FGDs and in-depth discussion with hiring independent agencies for evaluation community members and programme of the applications for NGPs and reportedly functionaries across all the 5 states, this came been paying Rs. 4,000 per GP towards the through clearly that certain sections of the evaluation. A proper system of monitoring and stakeholders believe that the NGP has become screening at the state/district level would help an agenda of the government offi cials and to save considerable amount of money, energy the offi ce bearers of the Gram Panchayat and and time which has hitherto been invested in lacks ownership at the community level. the NGP verifi cation process.

There is evidence to suggest that despite 4. Sustainability of open defecation free status ODF and fully sanitised’ status of villages attained by the GPs is a matter of concern. being one of the qualifying conditions for the There are allegations that in the rush to win eligibility of making an application for NGP, NGP, behaviour change is not accorded the the actual TSC implementation and monitoring importance it merits. As per available reports is largely limited to construction of IHHLs, from most of the states, a range of methods which is only one of the components of TSC are applied to attain 100% latrine coverage programme design. There is currently little for GPs, which also include false and over attempt at the state or district level to verify reporting at times. As there is invariably and certify the ODF and fully sanitised status a time gap (usually 2-3 months), between of villages applying for NGP strictly. In fact, declaration of ODF status by the concerned in certain cases ‘NGP’ appears to have taken GP and its verifi cation and confi rmation by a precedence over ‘TSC’, as is evident from GoI team, it is believed that the applying GP

Nirmal Gram Puraskar 45 Graph 2: Number of villages selected for NGP as against the number of applications

NGP- Application Vs Selection Year : 2008

1800

1600

1400

1200

1000 Applied selected

No of GPs 800

600

400

200

0 Bihar Chhatisgarh Haryana Karnataka Tripura

Applied 515 939 1604 594 179 selected 156 226 798 416 30

States

Source: DDWS website

would be able to achieve what they have confi rmed during the fi eld visits to 10 districts reported in advance. However, this is not across 5 states during this review exercise. always the case. As a result, at times, NGP verifi cation on the ground by GoI team is 5. In the independent verifi cation of the manipulated or/and stage managed leading proposed NGP villages being carried out by to a number of NGP awardees not being even agencies working on behalf of GoI there are fully covered by IHHLs and certainly not being reported cases of agencies seeking bribe ‘open defecation free and fully sanitised’, as and favours from the concerned GPs to revealed during fi eld visits to NGP villages in recommend them for NGP award. In one such Vaishali district of Bihar. case in Sarguja district, the concerned district collector (DC) caught the hired agency in the Another concern has been about the slippage process of trying to strike a deal with one of of NGP villages to the age old practice of the GP Sarpanches. The matter was shared by open defecation. The processes of community the DC in a press conference. The concerned mobilisation have a critical bearing on the agency is reportedly removed and blacklisted sustainability of the open defecation free status by the GoI following the DC’s report and achieved. It needs to be seen whether GPs recommendation. relapse to their earlier ways once the initial euphoria of an NGP award has died down. 6. While NGP has been the single most important factor in giving a much needed push UNICEF has undertaken a country wide study to TSC, there is an emerging need to revisit the on NGP conducted by an independent agency NGP award process and redo it in a manner which indicates that a large number of NGP that it does not undermine the credibility of GPs and villages are neither open defecation the award. Efforts of this nature are reportedly free nor fully sanitised. This has also been on within GoI.

46 Feeling the pulse 9. Role of Civil Society Organisations

TSC provides for multi stakeholder to build the capacities of functionaries participation in designing and carrying out the involved. campaign at the community, GP, district, and state levels. States have considerable amount 3. There is a lack of a partnership approach. of freedom and fl exibility to devise their Sahadat Hasan Mantoo, DDC, Nalanda, own innovative institutional arrangements shared that there has been no attempt to involving civil society organisations at build the capacity of NGOs in programme various stages of programme planning and implementation. The NGOs are working implementation. as contractors. Choice of NGOs for toilet construction was preferred as handling a In most of the states which include study few NGOs was seen as a better option than states of Bihar, Chhattisgarh, Haryana, to deal with a large number of individual Karnataka, and Tripura, role of CSOs, households. particularly NGOs, has been in the area of information, education, and communication The district administration is heavily (IEC) activities including wall writing, making dependent on NGOs for programme posters and pamphlets, organising street implementation. The district by way of its plays, etc. They have also been involved functioning style has not been able to create in start up activities such as collection of a partnership approach based on mutual baseline survey data; training programme trust. Moreover, most of the NGOs and the functionaries and community facilitators, PHED staff are not trained in participatory undertaking CLTS triggering in villages, and innovative approaches to implement and providing hand holding support for sustainable sanitation projects. There is no monitoring, etc. mechanism of learning from experiences of others by sharing on a regular basis, either 1. The relationship of line department within the district or from outside. programme functionaries and NGO colleagues have not always been smooth due a prevalent On the issue of the staff cost for NGOs and feeling of mutual mistrust or distrust. For their capacity building, Secretary, PHED was of example, in Bihar, Chhattisgarh and Tripura, the view that if they have to be provided staff an apparent mistrust in the capacity of NGOs cost, one might as well engage professionals to perform and deliver was seen to be there. from the open market directly. However, he In Bihar, NGOs are involved in TSC also as admitted that the capacity building of NGOs contractors responsible for toilet construction is an area that needs to be addressed by the at scale to make up for lost time in achieving department. coverage. The story in Nalanda district is no better. 2. In states like Haryana and Karnataka, Nalanda, being the poorest performing where NGOs have been involved as partners district in terms of household sanitation in programme planning and implementation, coverage, is somehow trying to improve energy and enthusiasm levels have been the achievement in terms of achieving high, results have been encouraging and numbers and there is apparently no focus easy to sustain. However, in most of the on qualitative aspects of the programme. places, there has been very little attempt The executive engineer said that though

Role of Civil Society Organisations 47 the programme should ideally be demand it is not on generating effective demand as its driven, it has actually become target driven precursor, the executive engineer stated that and therefore the approach is ‘Kisi tarah bana ‘Sab ideal ho jaye tab dena hai, ye nahi hoga’ dijiye’ (just somehow construct.). In reply to a (it is not possible to wait for ideal situation to question that the focus is on construction and provide toilets.

NGOs in Bihar: Terms of engagement and results As regards the quality of construction and related supervision and guidance, Rajendra Prasad, DDC, Vaishali in Bihar stated that NGOs construct toilets and concerned junior engineers verify them. Town Area Chairman Babloo Singh, present in the chamber of the DDC during discussion, commented that the policy of government is responsible for poor quality of construction of toilets. The district does not provide them (NGOs) staff cost. As only Rs. 25 per toilet are made available to NGO staff for constructing one toilet, the NGOs are compelled to compromise with the quality of construction as they spend much more in making visits to mobilise benefi ciaries, procure material and construct toilets. They also do not spend adequate time in hygiene education as they have to somehow construct and report the number along with toilet details and photographs to get their payment released. They also do not get suffi cient advance for construction and have to make upfront investment from their own resources to complete the work, the cost of which is reimbursed to them later.

48 Feeling the pulse 10. What has worked and what has not

TSC, which has been the most ambitious rural 1. While NGP emerges as the major factor in sanitation programme in the country and has accelerating the pace of sanitation coverage been on for almost a decade now, was almost in general, champions have made a difference a non-starter during the fi rst fi ve years and in achieving remarkable progress in places has experienced uneven progress across where TSC has done really well. The table different states and districts since 2004-05. below suggests that champions have really While some things have worked in some made a difference. places, some things have not worked to the extent expected. The table clearly shows that out of 10 districts across 5 states visited during fi eld study, three Eight years down the road, it is imperative districts had local champions, all of whom to study and draw insights about what has were government offi cials responsible for TSC worked and what has not to learn and fi ne implementation at the district level. These tune the programme implementation strategy are Sarguja (Chhattisgarh project sanctioned to achieve the desired objectives. in 2006.): Sirsa (Haryana, project sanctioned in 2003); and Shimoga (Karnataka project A study of available data and secondary sanctioned in 2005). These are incidentally the literature on one hand and primary data districts having both the highest sanitation generated during fi eld visits to Bihar, coverage and maximum number of NGP GPs. Chhattisgarh, Haryana, Karnataka, and Tripura on the other reveals what has worked and not Interaction with two of the three champions1 worked in the programme so far. (Ritu Sen and Khyaliya from Sarguja and

Table 1: Champions make a difference

State District Date of Coverage NGP Champion sanction Target Achievement % (Total) Bihar Vaishali 25/11/99 3,85,923 127,615 33.07 53 None Nalanda 12/03/03 3,10,799 6,020 1.94 3 None Chhatisgarh Sarguja 31/07/06 3,71,105 95,815 25.82 112 Ritu Sen (DDC) Rohit Yadav (District Collector, Sarguja) Dhamtari 15/07/05 1,11,991 59,995 53.57 17 Haryana Sirsa 20/02/03 63,511 63,511 100.00 270 Yudhvir Singh Khyaliya (ADC, Sirsa) Mewat 12/10/06 1,20,899 29,929 24.76 0 None Karnataka Bidar 17/05/05 1,67,539 46,064 27.49 0 None Shimoga 11/03/05 1,39,579 145288 104.09 171 Boragauda, CEO of Shimoga Tripura Dhalai 29/01/02 71,296 67,435 94.58 4 None North 18/09/01 80,903 78,137 96.58 6 None Tripura

What has worked and what has not 49 Sirsa respectively, revealed that they had Wherever PRIs (such as in Chhattisgarh, attended training and exposure visits and Haryana, and Karnataka) have been were driven by the desire to make a difference. actively involved in the campaign as However, on the basis of this it would be major stake holders the results have been naïve to conclude that training and exposure encouraging. visits can create champions, but there is no Inspired leadership, individual doubt that those carrying an innate desire champions5, particularly within to make a difference are more likely to grow government (both at state and district into champions given the right training and levels), and motivated community exposure. leaders have made a huge difference, as borne by the experience of Sarguja 2. Other common factors across these (Chhattisgarh), Sirsa (Haryana), and districts like innovative institutional Shimoga (Karnataka). arrangement, sound strategy, systematic Strategic planning and day-to-day planning, and close monitoring can also monitoring of planned activities have be attributed to the presence of these helped create open defecation free and champions and their ingenuity and fully sanitised communities at scale inspiration as leaders and change makers. with speed: Sirsa district in Haryana If champions are the ones who make things declared itself to be open defecation work, the question is as to how do they get free in a matter of 90 days following this created and what can be done to have many strategy. more of them. A dedicated cadre of trained programme functionaries and volunteers has made 3. In states like Bihar, Chhattisgarh, and things work on the ground, particularly Karnataka, there are reported to be sanctions in terms of effective mass mobilisation and government orders to the effect of and programme implementation and making IHHL a mandatory condition for monitoring support. elected representatives and community Community Led Total Sanitation (CLTS) level workers to be able to continue in their approach has triggered communities offi ces. But these sanctions do not seem to leading to open defecation free GPs. have worked as evident from a very lukewarm School sanitation in Sarguja (Chhattisgarh) response from the concerned functionaries has innovative features like monitoring and weak enforcement on the part of the chart on hygiene practices, force-lift concerned authorities. pumps for ensuring water availability in school toilets and bamboo fencing for A brief of what has worked and not worked in ensuring that stray cattle do not enter into TSC is given below. school premises and cleanliness could be maintained. What has worked 1 NGP has worked in accelerating the pace of A champion is understood here to be an inspired person/functionary who goes beyond her normal sanitation coverage in general, though the call of duty to put in additional energy and effort in pace of coverage has varied signifi cantly implementing TSC as a professional agenda of great across states and districts. urgency and importance.

50 Feeling the pulse What has not worked source of inspiration or motivation for Subsidy has not worked as states like adoption of sanitary practices. Bihar and Chhattisgarh with a high subsidy A primarily state led and supply driven regime including subsidy provision for approach such as in Bihar has not worked APL households has not really worked, as even in terms of achieving good coverage; the rate of growth in sanitation coverage usage and sustainability aspects have of these states has been much slower suffered further with practically no impact than the ones with a lower or no subsidy on behaviour change. approach such as Haryana. The assumption that sanitation needs of Conventional IEC with activities like wall all sections of society will be addressed, writings, posters, pamphlets etc have not without any specifi c emphasis on the needs been able to create the kind of awareness of the marginalised groups such as women, that generates demand for sanitation Scheduled Casts and Scheduled Tribes, the services. None of the respondents from aged, disabled and people with HIV AIDS. 40 GPs in 20 blocks across 10 districts in Financial and physical monitoring as an 5 states mentioned any of these as a indicator of safe environment.

What has worked and what has not 51 11. Emerging Directions: Targets, Triggers and Total Sanitation

‘One of the objectives of TSC is bringing about an improvement in general quality of life in rural areas. This objective cannot be met if general cleanliness of villages is not maintained properly. PRIs are required to put in place mechanisms for garbage collection and disposal and for preventing water logging...’ - TSC Guidelines Dec 2007

Given the experience of rural sanitation Making PRIs active stakeholders in the programme initiatives of more than two process of achieving the objectives of total decades in the country, it has become sanitation and sustaining it. increasingly clear that state led, supply driven Measuring outcomes. approaches to rural sanitation do not really work in terms of increased sanitation coverage, usage and behaviour change. Another learning Recommendations as per the fi ndings of this study has been that monetary incentives can work only in a limited In view of the fi ndings of the study, the manner, but are not enough to bring about following recommendations are made to fundamental shifts in attitudes and mind sets optimise the benefi ts of TSC: leading to sustained behaviour change for adoption of safe sanitation practices. Policy TSC is currently a guideline. A national Though the policy principles of the programme sanitation policy that clearly articulates being community led, people centered, and Government of India’s policy and position demand driven are enshrined in the TSC need to be in place. This policy needs to Guidelines, it has been hard to translate them address various issues such as inclusive into practice due to deep rooted individual processes, investment priorities, expected and institutional orthodoxies and mind public health outcomes and their sets around issues of subsidy, technology, monitoring, menstrual hygiene, subsidy/ involvement of NGOs etc. This has resulted incentive, institutional arrangements in a deep disconnect between policy and including role of PRIs, CSOs, and practice/intention and action on one hand, communities, community mobilisation and action and outcomes on the other. approaches, technology as a factor in safe sanitation. In the current context, possible Some of the key challenges in the programme impacts of disaster including climate are as follows: change on provision of sanitation services Striking a balance between triggers and appropriate solutions needs to be (of behaviour change) and targets (of identifi ed. coverage and NGPs). Ensuring active involvement and provision Programme Design and Delivery of services to women, poor, and the TSC implementation strategy is revisited marginalised such as SCs, STs, the and revised to focus more on usage disabled, aged etc. of sanitation facilities created and the

52 Feeling the pulse related behaviour change so as to achieve sustained use of the sanitation facilities the objective of improvement in the created. quality of life of people in rural areas. The Incentive/subsidy money is used to award revision needs to be made in terms of rural communities after they are open making the programme truly community defecation free and fully sanitised and not led and demand driven as against the to individual households. state led and target driven approach being Special focus on engagement with and adopted in several states and districts meeting the needs of marginalised groups currently. such as women, tribals, Scheduled Castes States and districts could place greater the disabled and the aged. emphasis on strategy development Menstrual hygiene is included as a and effective action planning for TSC programme component of the campaign. implementation followed by monitoring, follow up and corrective action, as Institutional Actors and Agencies required. Effective and timely realisation and In line with the stated TSC strategy of utilisation of funds allocated for sanitation the programme being ‘community led’ through the removal of bottlenecks and and ‘people centered’ and in view of the wherever needed, capacity building. success of CLTS in Haryana, community led PRIs are oriented and strengthened to total sanitation (CLTS) could be one of the engage communities in self analysis of approaches explored for faster and more their sanitation situation followed by sustainable results on the ground. collective local action to achieve the Ecosan could be one of the options while objectives of total sanitation. sharing technology options with the NGOs and CBOs such as SHGs are actively communities in the process of planning for involved in community/social mobilisation, ODF and fully sanitised environment. school sanitation and hygiene education, Planning for total sanitation at the monitoring of programmes and outcomes. community level is also based on Champions and community leaders hazard and risk assessment at the local other than GP Sarpanches are actively level related to possible disasters and considered for felicitation under NGP so emergencies such as fl oods, drought, as to keep motivation levels high. These earthquake, landslides and cyclones. champions could also include government An assessment of the possible impact offi cials. of climate change and the resultant adaptation needs of communities to Monitoring and Learning provision of sanitation facilities. Deepening of monitoring by taking it The IEC component of the programme is beyond coverage to include usage, re-oriented to engage in more effective behaviour change, and health benefi ts behaviour change communication (BCC) accrued because of TSC. This could be strategies, which have been more of done by complementing on line TSC rhetoric than reality so far. IEC needs monitoring system with periodic fi eld to focus more on establishing a link based reviews and community monitoring between improved sanitation and its systems. Community based water quality impact on the collective health to ensure monitoring through convergence with

Emerging Directions: Targets, Triggers and Total Sanitation 53 the Rajiv Gandhi National Drinking Water technology innovations suitable Quality Monitoring and Surveillance to particular climatic, social and Programme could provide data on geographical conditions. immediate impact of sanitation. Develop on effective community strategy Design and implement a system that mobilises communities, addresses all to recognise and encourage local concerns and offers cross learning.

54 Feeling the pulse Section 2 State Reports

2.1 Bihar

Background

Bihar, which is the 12th largest state in terms of geographical size and 3rd largest by population, has close to 85 per cent rural population. There are 8,471 Gram Panchayats spread over 534 blocks across 38 districts. Bihar Rural Sanitation Coverage: An Overview Status At census Achievement against Overall TSC target Achievement TSC Target Total No of HHs with HHs without Numbers Percentage Percentage Rural HHs Toilet Toilet 12,757,830 1,765,061 10,992,769 11,171,314 1,151,177 10.30% 22.54% Source of data: DDWS website, 15th October 2008 In Bihar as per Census of India 2001, commenced in 2000-01 with an objective to sanitation coverage was 13.83% with achieve coverage of 1,11,71,314 households. 17,65,061 households having toilet out of The current coverage stands at 10.30% as the total 1,27,57,830 rural households. TSC against the physical target.

Graph 1 Year wise progress of IHHL in Bihar

500000

450000

400000

350000

300000 BPL 250000 APL 200000

150000

100000 Number Constructed 50000

0 1999- 2000- 2001- 2002- 2003- 2004- 2005- 2006- 2007- 01 01 02 03 04 05 06 07 08

BPL 0 0 0 723 32250 57433 46848 136006 468943

APL0000009680 29306 150110

Year

Bihar 57 The graph summarises the year-wise progress which is being promoted after the launch made in toilet construction. During fi rst three of LSY in year 2007. years 01/02 no progress was reported. In all With a physical target of around 99.3 lakh 7,42,203 (13%) BPL category households and toilets to be constructed by end of 2012 some 1,89,096 (4%) APL category households there is a need to mobilise huge amount of have been provided with toilets, making an resources both physical and fi nancial. This overall progress of 9,31,299 toilets or 9%. would require constructing some 2.07 lakh About 534 community toilets have also been toilets per month as tabulated below. constructed till end March 2008. Table: Target of Toilets in Bihar Construction of toilets in schools has steadily been on the rise since 2005-06. Till March IHHL Per Year Per Month 31, 2008 some 24,741 toilets have been BPL 50,85,716 12,71,429 1,05,952 constructed in schools, and 618 toilets have APL 48,44,588 12,11,147 1,00,929 been constructed in Anganwadi as against Total 99,30,304 24,82,576 2,06,881 proposed targets of 76,581 and 6,595 respectively. Given these targets to be achieved with the current subsidy pattern, some Rs. 1133 crore (as summarised in the table below) Key Findings would be required in next 4 years. This TSC is now one of the priority programmes means mobilising Rs. 283.39 crore ever of Government of Bihar especially after its year or Rs. 23.62 crore every month. inclusion in fi ve-point agenda of the Chief And, accordingly supply chain has to be Minister. The fact that sanitation is high on maintained. the state agenda is also borne by the fact that the state has launched ‘Lohia Swachta Table: Financial Requirement Yojna’ (LSY) that is being implemented in all the 38 districts of the state. Rs. Crore Per Year Per Month Subsidy is perceived to be the foremost BPL 406.86 101.71 8.48 driver for toilet construction, thus the APL 726.69 181.67 15.14 state government under LSY has sought Total 1,133.55 283.39 23.62 to provide additional subsidy in the nature of promotional amount to both To take care of all training and capacity APL and BPL households. APL house development requirements of the state hold would receive Rs. 1,500 and BPL Pranjal an autonomous training institute would receive Rs. 500 over and above the has been established within PHED. It is incentive provided for under TSC. Thus being set-up on some 3 acres land with the total amount of subsidy for APL is a budget of around Rs. 5 crore. Some six 1,500 and for BPL it is 1,700. consultants, from disciplines like health, Benefi ciary share for BPL families remains IEC, software, human resources etc., will the same as before (Rs. 300), while for APL be part of the institution. families it is kept as Rs. 500. This is based A unique Mass Awareness Campaign, on the total cost of off-the-pit design of was launched by the Chief Minster and toilets estimated to cost around Rs. 2,000 the concerned Cabinet Ministers. Under

58 Feeling the pulse this campaign vehicles with sanitation toilet is provided in two parts – Rs. 15 for messages displayed all over its body motivating household for toilet usage, and plied in each block for 5 days and demand balance Rs. 5 after six months for ensuring for constructing toilets was registered usage. However, in practice the entire through a pre-designed requisition form. amount is being paid in a single installment. This campaign took place in two phases There is an apparent push for construction - during 10-14, January, 2007 covering 20 of latrines bypassing the behaviour change districts and 336 blocks and during 12- aspects. Lack of demand can be considered 16 March, 2007 covering 18 districts and as an indicator of poor IEC efforts. The 198 blocks. With this effort demand for health aspect of improved sanitation is 5,59,170 toilets was generated. 2,76,992 missing from the promotional strategy. in Phase-1 and 2,82,178 in Phase-2. Many feel that the non-availability of Under IEC initiatives about 50 wall committed NGOs has been a major writings were planned for every GP. gap in implementation of TSC in Bihar. Though wall writings were observed in NGOs have been mainly engaged to take the villages visited, size of display was care of construction of IHHLs, and not not enough to catch people’s attention. for awareness creation or community At many locations it has been done on mobilisation. narrow cement electricity poles making it The coverage rate for school sanitation totally unreadable. It was explained that has also suffered reportedly for non- households do not allow painting walls availability of land for construction of toilet with messages. However stakeholders at in some 10,000 schools. the district level feel that these messages It is felt that there is lack of capacity at are not effective to draw attention of the the level of the PHED to carry out and community and follow them in practice. supervise mobilisation/motivation, Efforts have been made to include PRIs awareness creation, demand generation, in the programme. Capacity building of construction and supervision, cost PRIs (GP, BP and ZP level) have been sharing and MIS etc. Even the account undertaken to help develop better maintenance is cumbersome, and understanding about the issues related to accounts people need training to present improved sanitation. the accounts as per TSC Guidelines. On the supply side extensive training There are 39 Executive Engineers in position programmes have been organised where to take-up responsibilities in 38 districts more than 4,000 masons have been and state headquarters. Many feel that the trained and identity cards issued to them. TSC work is an additional burden over and Five volunteers per panchayat have been above the regular departmental work and trained for water quality monitoring. without any additional benefi ts and staff. Awareness and orientation has been There is a demand for forty more EEs. done both at panchayat and block level PHED has its internal review system targeting benefi ciaries, ward members etc. for routine works and TSC is also being To ensure usage and get a feedback on reviewed with Executive Engineers under the same a system of providing incentive this system. There is no dedicated review to motivators has been designed. The and monitoring system at the district level incentive of Rs. 20 per household with for TSC.

Bihar 59 Offi cers are being sent to nearby states on exposure trips to learn and use the learning for accelerating the pace of toilet construction. It is proposed to establish a separate structure at district level by July 2008. One data manager is proposed to be placed at every division for information and data management. At village level convergence of resources like ASHA, AWC, pump operators, BLW etc. would also be made with PHED initiatives. Greater emphasis is now being laid on capacity building. School Toilet in Nalanda

enhanced to strengthen the programme Emerging Issues implementation. Active involvement of PRIs and self help In view of the above fi ndings, the issues that groups of women need to be ensured emerge to be of signifi cance from the point of in awareness creation and community TSC implementation strategy in the state are mobilisation efforts so as to create a sense as follows: of ownership of sanitation agenda at the There is an urgent need to revisit the local level. current programme implementation Coordinated efforts including inter strategy, as it has not been able to achieve departmental coordination at all levels the desired coverage, but has also been are required for strengthening school incapable of taking care of usage and sanitation and hygiene education. behaviour change aspects of sanitation. There is also a need to revisit the content As the state is lagging behind in sanitation and delivery of IEC activities to ensure coverage at 22.56%, which is less than half the inclusion of health issues in message of the current national coverage of 56.19%, design and positioning. the new strategy has to be built around the Quality of construction emerges as a objective of doing sanitation at scale with major issue to be addressed, as in many speed to make up for lost time. places people even from the poorest of Ensuring timely availability of funds is the poor communities such as dalits fi nd another important issue that needs to the constructed toilets disgusting and be addressed; as the delay in release of unusable. Hence, a strong mechanism payment from GoI has been reportedly for monitoring construction quality due to lack of availability of agreed state needs to be devised and put in place, share, the state government has to make besides strengthening the supply chain arrangements to make its share available management. in time. There is a strong need to shift focus Staff capacity both in terms of from mere coverage to creation of ODF numbers and upgradation of existing communities in line with the true spirit of knowledge, skills and attitude have to be TSC and its objectives.

60 Feeling the pulse 2.2 Chhattisgarh

A relatively new state populated by 20,795,956 people (census-2001), which separated from the bigger Madhya Pradesh state, Chhattisgarh has one of the lowest levels of urbanisation in India and has the second highest percentage of tribal population in India after the state of Madhya Pradesh. The Scheduled Tribes constitute around 43.4% of Chhattisgarh’s population, Panchayat and tribal Affairs. Out of the total mostly concentrated in the southern, northern 16 districts 1 received sanction during 2001, and north-eastern districts of the state. The 5 during 2003,4 during 2005 and 6 districts highest concentration of tribals are found in during 2006. the district of Dantewara (79%), the erstwhile Bastar district has the second largest tribal The 2001 census estimated the total number population (67%), followed by Jashpur (65%), of rural households in Chattishgarh at Sarguja (57%) and Kanker (56%). The Gonds, 3353978 out of which 169460 HHs had the Oraons, the Abhuj Maria, the Bison Horn access to sanitary latrine and 3184518 Maria, the Muria, the Halbaa, the Kawars, the HHs who defecated in the open. Getting Halbis, the Dhurvaa, the Bharias (Bhumiars), the people in Chhattisgarh to switch to the Bhattras and the Napesias are the main indoor toilets, thereby abandoning age- tribes of Chhattisgarh. Literacy rate has old practices, reportedly presented a improved steadily from 42.91% in 1991 to major challenge for government offi cials 64.7% in 2001; registering a growth of 21.79%. implementing the TSC. Against an overall objective of achieving a physical target of The Total Sanitation Campaign (TSC), 33,65,426 the project has achieved the fi gure launched under the aegis of the Ministry of of 9,37,881 which is 27.86%. Rural Development’s Department of Drinking Water Supply, is being implemented in TSC had a very slow progress in the state in the the state by the Public Health Engineering fi rst 5 years (2001-2006), when toilet coverage Department (PHED). The multi-pronged remained limited to 6% till the end of 2006. strategy implemented by the state involves However, it has picked up during the years capacity-building, awareness, logistics 2006-2007 and 2007-2008. During this period and participation and is overseen by a core individual household latrine (IHHL) coverage committee under District Magistrates with has gone up from 6% to 30%, which is notable members from the PHED and the Departments improvement as compared to the performance of rural Development, Public Education, of the programme during the years 2001-2006

Chhattisgarh Rural Sanitation Coverage: An Overview Status At census Achievement against Overall TSC target coverage TSC Target Total No of HHs with HHs without Numbers Percentage Percentage Rural HHs Toilet Toilet 33,53,978 1,69,460 31,84,518 33,65,426 9,37,881 27.86% 32.90%

Chhattisgarh 61 Graph 1: Year wise progress of IHHL in Chhattisgarh

300000

250000

200000

BPL APL 150000

100000

Number Constructed 50000

0 1999- 2000- 2001- 2002- 2003- 2004- 2005- 2006- 2007- 00 01 02 03 04 05 06 07 08

BPL 0 0 0 0 892 4312 20832 110505 258980

APL 00000 42 3000 178449 247742

Year in the state (See Graph 1). Apart from the there are a combination of factors infl uencing incremental coverage the state has bagged the performance of the state under the TSC 12 and 90 nominations under Government of programme and key factors are summarised India’s prestigious Nirmal Gram Puraskar (NGP) below: in 2005 and 2006 respectively. In 2007, 938 The keenness of the state leadership to GPs and 5 blocks have been nominated for NGP. accord priority to sanitation as one of the Reportedly, as per the current growth rate under major development objective has provided the programme the state is counted as one of the much appreciated administrative and the 5 better performing states in the country. political push to the programme. The chief According to state offi cials, the state would be minister declared about two years ago that able to achieve MDG target related to sanitation 10 Lakh toilets would be completed in the by 2012, 3 years ahead of the MDG deadline. state by December 2008 and an amount of Rs. 50 crores has been allocated in the current year for school sanitation. Besides Key Findings the programme is one of the seven priority programme, which the Chief Minister Interactions, interviews, and discussions with himself directly reviews every quarter. The a range of stakeholders have revealed that programme is also regularly reviewed by

62 Feeling the pulse the Chief Secretary, Secretary of PHED Organisations like WAI are trying to give and the Engineer-in-Chief. TSC has also increased momentum to the campaign acquired many champions at the state and by supporting the State in organising district level. The following statement of events to mark the International Year of the Engineer-in-Chief, PHED, R.N. Gupta, Sanitation at the state and district levels. exemplifi es this point: “about 6-7 years While workshops have been held, a ago TSC was not my priority, as I had no sanitation week is being planned across belief that it would ever be possible to Chhattisgarh. change the behaviour of people. But now The CCDU is fully established and is TSC has become my top priority as I saw believed to be one of the reasons for the it happening in places like district Sarguja programme as a whole picking up across where the young and energetic collector the state. and his wife who is the DDC of the district There has been a general shift from have made a difference.” involvement of NGOs to increased In some districts, the District collectors involvement of government functionaries have led from the front in initiating the and PRIs, particularly the Sarpanch and drive and monitoring the progress in a very the Panchayat Secretary at the Gram committed manner. The district collector Panchayat (GP) level in the implementation of Sarguja and visited each of the 256 GPs of the programme across districts. There undertaken for implementation in the fi rst is a growing understanding among all phase. This has sent the message among the stakeholders that active involvement the offi cials as well as the communities of the PRIs is key for the long term that the programme is important and sustainability of improved sanitation everyone has to do the best to make it and this has a positive impact on the successful. Fortnightly reviews have been programme performance. undertaken at the level of the collector A conscious effort has been made to where all concerned including CEO janpad make community monitoring an integral panchayat, (BDO), Tehsildar, SDM, line part of the overall strategy along with department offi cers used to be present departmental monitoring. For example in Other factors that seem to have district Sarguja Toka-Toki Samitis (village contributed to an improved performance level monitoring and vigilance committee) of the programme in last one year inclusive of ward members, women and include application of community led other members of the community (at least 2 total sanitation (CLTS) approach in per ward) have been formed in the villages Bilaspur district and Nirmal Agraha i.e. with the aim to stop the villagers going out development of a cadre of committed for open defecation. A fi ne of Rs. 500 has volunteers in Rajnandgaon district of also been fi xed for the defaulters but it has the state. Both these initiatives have worked more as a threat as no one has been been facilitated by UNICEF, which has actually fi ned as yet been providing strategic support for Government of Chhattisgarh has a TSC implementation in some selected strong subsidy regime to promote total districts in the state, apart from sector sanitation in the state. Initially the amount wide support in terms of staff and capacity was pegged at Rs. 3600 which has been building. subsequently brought down to Rs. 2,200

Chhattisgarh 63 for BPLs. In fact, over and above the toilets having painted with pictures of ‘incentive’ of Rs. 1,200 for below poverty animals, institutionalisation of daily line (BPL) households by the Government monitoring of sanitation and hygiene of India, the state government has habits of children through monitoring introduced an additional subsidy of Rs. charts developed for the purpose etc. 1,000 for BPL and Rs. 1,900.00 for above Toilets have also been constructed in poverty line (APL) households. This Anganwadis, including those that are additional amount is being resourced from being run out of rented buildings, on the the 12th Finance Commission funds by the basis of cost sharing arrangements with state, and being justifi ed on the grounds of the landlord. However, use of these toilets extreme poverty in large parts of the tribal is suspected to be poor. The state has a dominated state. School sanitation is fully plan to install force-lift pumps (started subsidised. with support from UNICEF to begin with) in However in the District Sarguja the all the schools. A provision of around Rs. district administration has consciously 40 crores has already been made for this in downplayed the subsidy as provided the budget of the current year. under the state subsidy plan for There has been an atmosphere of general superstructure. The underlying mistrust regarding the involvement of assumption of such a step has been that NGOs in TSC work. One of the contributory participation of the benefi ciary would factors seems to be the experience of Durg enhance ownership and would result in district where the work remained stopped improved usage of the toilet. for around 2-3 years due to irregularities There is an enhanced focus on school and mismanagement of IEC funds by NGOs sanitation and hygiene education (SSHE) in the erstwhile Sector Reforms Project, component of TSC in the state. There amongst other reasons. Actions were is reportedly a SSHE draft state plan taken against NGOs and departmental submitted to the state cabinet for its offi cers and this also had an impact on approval (copy of the state plan could the TSC programme. The district is back not be accessed by the review team as on track now. Some 21 GPs have been it is apparently not in the public domain proposed this year for NGP. as yet). Some 14 workshops have been Government of Chhattisgarh is now moving conducted in 14 districts where DWSC towards convergence with NRHM, where and line departments have been trained they are preparing Gram Swasthya Evam on SSHE action plan. In some schools the Swachta plan (village health and sanitation concept of Bal Sansad (Child Cabinet) has plan) which is proposed to be piloted in been introduced. 20% of the GPs in each block in the fi rst Children have been groomed to act as phase. The state is making efforts to change agents in the whole process and facilitate NGP gram panchayat to move there has been a conscious attempt to towards swastha gram panchayat (GP). initiate sanitation promotion from the RSMs and Production Centers have been schools. Greater focus has been placed on promoted only in a very limited manner. School Sanitation and Hygiene Education Centralised purchase of toilet pans is (SSHE). The innovative measures include presently being made and procurement is installation of child friendly toilets, school carried out as per the CSID rate list. Some

64 Feeling the pulse districts like Sarguja have taken initiatives move to activate SWSM with support from to stabilise prices of raw material like UNICEF. It was reported that it is diffi cult bricks and cement. to really activate the SWSM because it Involvement (both physical and fi nancial) consists of high profi le offi cials who have of households in the design and other priorities and pressures on their construction of superstructure has been time. ensured in district like Sarguja so that their An area of concern in the state is also preferences are taken into account. At the the inadequate attention being given same time Quality of construction of the to the quality of construction of toilets. sub-structure of toilets has been found to Technical supervision, given the shortage be poor in some cases in district Dhamtari. of engineering staff at the district level- Technology gaps is also apparent in the PHED or the RES- is inadequate. Poor construction of IHHL in many cases. quality of construction may affect the The spread of naxalism has reportedly ground water conditions on one hand and restricted the outreach of government may lead to the collapse of the structure offi cials in many areas of Dantewada, on the other. There is also a veritable Narayan pur, Rajnandgaon and Kanker threat of households reverting back to creating functional problems in programme open defecation if they are unable or implementation. unwilling to spend on maintenance. There are issues of institutional legitimacy Linkages of adequate sanitation with and legality stemming from the current health is conspicuously absent in the strategy of making village Water and strategy being adopted and consequently sanitation Committee (which does not in the understanding of the community. form part of the GP) responsible for Toilets are at present seen as a matter of implementation of the programme at the convenience rather than as a means for village level. There is apparent confusion ensuring better health. While convenience among offi cials about the legality of as a motivating factor for the use of transfer of TSC funds to VWSC. sanitation is suffi ciently powerful to be used as tool, the internalisation of health benefi ts is expected to bring about Emerging Issues sustainable behavior change. Currently TSC has acquired a priority status both at the toilets appear to be used only during political and administrative level over the particular times in the year and by only last one year. However, TSC has become some members of the household. synonymous with NGP and the focus While subsidy may be justifi ed in some continues to be individual household of the poorest pockets and communities, latrine (IHHL) coverage. As a result, subsidy in its present form would be coercive rather than promotive methods counter productive in ensuring ownership are more in use at the Gram Panchayat and usage of toilets. level, which raises questions about the The need for champions amongst the key sustained use and maintenance of the offi cials at the district level is evident, toilets. given the better performance of some SWSM, though set up in the state, has of the districts as well as innovative yet to be really functional. There is now a approaches being adopted here.

Chhattisgarh 65 There is a clear trend towards transferring Total sanitation is being construed mainly as the responsibility for implementation on coverage of sanitation infrastructure in terms of to the GP – more specifi cally the sarpanch IHHLs. Following from this, the linkage between and the secretary. While on one hand this sanitation and health is also conspicuous by requires increased capacity building of its absence, as also a planned effort to sustain the functionaries, it also needs to have use and maintenance. The thrust is almost an inbuilt process of information sharing, completely on construction of toilets and community participation and monitoring. ensuring an ODF village in the short term.

66 Feeling the pulse 2.3 Haryana

Haryana is a state situated in the northern part of India surrounded by Uttar Pradesh on the east, Punjab on the west, Uttaranchal, Himachal Pradesh and Shivalik Hills on the north and Delhi, Rajasthan on the south. Haryana’s economy is largely dependent on agriculture. About 70% people of the total population are engaged in farming. It consists of 20 districts and 119 development blocks.

Haryana Rural Sanitation Coverage: An Overview Status At census Achievement against Overall TSC target coverage TSC Target Total No of HHs with HHs without Numbers Percentage Percentage Rural HHs Toilet Toilet 26,11,842 7,43,226 18,68,616 17,85,097 14,05,066 78.71% 84.96%

The project information on the DDWS 17,85,097 rural households under the website reveals that out of the total TSC programme. Till 15th of October 2008 number of 26,11,842 rural households the project had achieved 78.71% physical (Census 2001) only 7,43,226 (28.46%) coverage as against the target. Out of the owned sanitary toilets and the remaining total 20 districts the programme began the 18,68,616 households had no such access. implementation in 2 districts during the year Against this backdrop the state set out 2000, 11 districts during 2003, 4 districts to achieve a physical target of covering during 2004 and one district during 2006. Graph 1: Year wise progress of IHHL in Haryana

600000

500000

400000

BPL 300000 APL

200000

Number Constructed 100000

0 1999- 2000- 2001- 2002- 2003- 2004- 2005- 2006- 2007- 00 01 02 03 04 05 06 07 08 BPL 0 0 0 0 38530 46083 44547 66592 166611 APL 0 0 0 99 2426 10806 97616 221942 491991

Years

Haryana 67 Despite an early start in most of the districts The strategy has been to engage the the progress was very slow till the year 2006- communities in target GPs to carry out self 07. The state has reportedly achieved an analysis of their own sanitation profi le. impressive coverage of more than 70 % of the This is based on the perception that target set out to be achieved by the project in once the community understands and a matter of two years. internalises the adverse impact of open defecation, on the collective health, it Progress of coverage under school sanitation would seek solution on its own through and anganwadi sanitation has also been local collective action. impressive as suggested by the following The emphasis of the strategy has been fi gures available on the website of DDWS. on ensuring sustained behaviour change rather than on construction of toilets. The Proposed Achievement stakeholders across all levels feel that School toilet 7,029 7,137 there is no point in constructing toilets Anganwadi 6,531 5,637 until and unless the community is fully toilet mobilised and actual demand springs up from within it. The state has bagged 60 NGPs during the year The major trigger that made people change 2007 and for the year 2008 the state has sent their behaviour included the realisation nomination of 1604 GPs, 8 BPs and one ZP that open defecation practically meant for selection for the prestigious Nirmal Gram eating each other’s shit. Puraskar. Sanitation workers in all the districts of the state have been trained in the CLTS approach through a 5 Day training module. Key Findings The fi rst such training was held in the The State Government in view of the slow Bhiwani district way back in July 2006 and progress took a decision of using the the success of the approach led to demand innovative community centered approach from other district as well. widely known as Community-Led Total Champions from within the district Sanitation (CLTS) to scale up the TSC. The administration have contributed fi rst CLTS orientation workshop rolled considerably to the success of the out during July 2006 in Bhiwani district. programme. As observed by the state Haryana has done well in TSC in the past coordinator, strategy and leadership has two years following this. been the key for success achieved under District Sirsa has successfully the programme. demonstrated that open defecation free There has been a strong ownership of the (ODF) environment can be achieved on programme at the State level. Conviction scale and with speed, as the entire district and support of the Principal Secretary and was made ODF in a matter of 90 days. the commitment of State TSC Coordinator This was reportedly made possible by have provided enabling environment for undertaking TSC in a campaign mode with making the programme community led. massive mass mobilisation, meticulous There has been an intelligent mix of CLTS planning, and day to day monitoring of the and reinforcing interpersonal contact in programme. mobilising collective action which is a

68 Feeling the pulse unique aspect of strategy adopted in the as torchbearers and mobilised collective state. action to stop open defecation. In some cases the use of mass Shortage of staff, lack of motivation among communication for reinforcement of available staff, and lack of involvement of messages after triggering community for line departments in the implementation collective behavior change has yielded of the TSC have been the main reasons for results. Swachhta Rath, (sanitation poor performance in district Mewat. chariot), mass media campaign using Subsidy focused approach to sanitation print and visual media focusing on the by NGO working in the Mewat district has hazards of open defecation have been very created a dependency syndrome and spirit effective in fanning the fi re. of local collective action is lost. Exposure visits, to ODF GPs in Inclusion is not an issue as wherever CLTS Maharashtra, Tamil Nadu and Kerala has been facilitated, care has been taken as part of state initiative, were useful to involve people from all castes and in creating conviction among the Gram religions in the process. Pradhans about the feasibility of achieving Lack of water has not been a barrier in sanitation outcomes. adopting construction and use of toilets Wall paintings displaying sanitation and stopping open defecation. For messages in specifi c part of the districts example, GP Ferozpur Rajput in district have been installed. However, the State Mewat where people purchase drinking TSC Coordinator is of the view that the wall paintings have not been able to create much impact. The interpersonal communication as part of CLTS has made the difference. In most of the districts, the strategy has been to target students (both children and adolescents) as change agents, which many in the state and district circle feel to be one of the factors that contributed to the success of the programme. Chhatra Jagruk Dals (Student vigilance cell) have been formed who would blow whistle (provided to them from the project IEC funds) on people defecating in the open; organise rallies in the village etc.. There has been a conscious and visible attempt to involve women as well in the programme through their groups or otherwise by having meetings in their respective clusters or by participating in surveillance to check open defecation as members of Nigraani Committee. In Sirsa the women collectives functioned Individual Household Latrine in Mewat

Haryana 69 water for drinking from private vendors district but in absence of the systematic has become open defecation free. Largely, institutional arrangements, the efforts the toilets are being maintained properly. of continued surveillance, monitoring Reportedly the progress has been behaviour change indicators and handling comparatively slow in villages inhabited by the deviants at the community level are the “Mev” community, which is a martial not being taken care of. race with a closed society that does not The inadequacy of the funds under TSC has believe in education, particularly female impacted the follow-up activities aimed to education. These communities look up to sustain the collective ownership, facilitate the government for everything, as the role other safe practices related to hygiene and of government and NGOs acting in the area sanitation. has been more of a provider rather than Some of the recent steps of the state facilitators of empowerment process. government have opened new dimensions Villages not dominated by “Mev” in TSC. These include: community ( for example GP Bajada Pahari Launching a state incentive scheme to and Ferozpur Rajput of district Mewat) promote competition among GPs. were found to be more receptive to Steps undertaken to improve menstrual behaviour change than those having large hygiene by making available sanitary number of Mev community. High rate of napkins through women SHGs. literacy, exposure and connection to cities Appointment of Safai Karmi (sanitation have been important favorable factors in worker) in each Gram Panchayat these cases. Efforts to control mosquitoes by In some of the villages where CLTS was popularising gambusia fi sh that eats triggered, efforts have been made by the larvae of mosquitoes. communities to construct and maintain Villages where CLTS has been triggered, community toilets for migrant agricultural there has been some change in the laborers. However, the issue needs to be practice of disposal of solid waste such addressed in many other villages. as cow dung etc... Some households Technology safeguards have been by- have started disposing it in compost passed in many a toilet constructions pits. However, more robust efforts are in Sirsa district. The thrust on providing options of technology to the community was deliberately postponed and it has led to adoption of traditional dry pit latrines, commonly known as Kui (the depth of which ranges from 20 to 40 ft. also known as Dhamaka latrines) causing a threat to ground water quality. The DRDA & ADC admitted this deliberate decision, as the entire focus of the campaign was to facilitate the complete stoppage of open defecation through collective decision and ownership. The campaign has resulted in the attainment of ODF status of the entire Sirsa Village surrounding in Mewat

70 Feeling the pulse needed to promote solid and liquid waste reportedly made for seeking permission management. to use that money to ODF GPs for other Hand washing and personal hygiene is development purposes, which has yet to another area where concerted efforts need come through. to be given. There is a widespread practice in most of the districts across Haryana to dig large and deep pits (including dhamaka latrines Emerging Issues in Sirsa) for toilets as they are believed to take longer in fi lling up. This carries a In the context of Haryana, some of the real risk of contaminating ground water. emerging issues in TSC implementation are as This issue needs to be examined in depth follows: and appropriate cost effective and safe In district Sirsa where subsidy/incentive technology options need to be worked factor is being under played to promote out and presented to people as per local community processes, use of unspent conditions. IEC campaigns also need to incentive money has come up as an issue address this issue by educating people on to be addressed. A request to GoI has been implications of inappropriate technology.

Haryana 71 2.4 Karnataka

Karnataka is the eighth largest state in India in both area and population. It was formerly known as Mysore. On 1 November, 1973, the name Mysore was changed to Karnataka. Geographically, Karnataka occupies three natural regions like the Coastal strip, the Sahyadris and the Deccan plateau. They are known in Kannada as Paschima Karavali, Malnad and Maidan respectively. The state consists of 27 districts.

The Total Sanitation Campaign (TSC), launched under the aegis of the Ministry of state set out to achieve a physical target of Rural Development’s Department of Drinking covering 54,27,370 rural household under the Water Supply, is being implemented in the TSC programme. state by the Karnataka Rural Water Supply and Sanitation Agency (KRWSSA). At the As against this the programme as on district level, the Zilla Panchayats (ZPs)_ are October 15, 2008 had achieved 29.66% made responsible for Project Management. physical coverage with 16,09,914 toilets Dedicated multidisciplinary District Support constructed. Units (DSUs) have been set up under the ZPs to assist the ZPs and to act as facilitators. The year wise progress as presented in Out of the total 27 districts the programme the graph given below, suggests that the began implementation in 3 pilot districts momentum started picking up in 2004-05 viz, Mysore, Dakshina Kannada and Bellary and has been steadily rising since then from 2000 and in the remaining 24 districts through the years of 2005-06, 2006-07 and the scheme is being implemented from 2nd 2007-08 (See Graph 1). However, if one October, 2005. looks at the overall percentage of IHHL coverage which is 29.27 ( about 15,88,658 The project information in the DDWS website households), it is evident that the journey so reveals that out of the total number of far has not been very impressive despite the 66,87,839 rural households (Census 2001) fact that the state had the benefi t of a World only 12,05,170 (18.02%) owned sanitary toilets Bank supported Programme in Jal Nirmal and the remaining 54,82,669 households had which had a strong focus on sanitation long no such access. Against this backdrop the before the launch of TSC.

Karnataka Rural Sanitation Coverage: An overview

Status At census Achievement against Overall TSC target coverage TSC Target Total No of HHs with HHs without Numbers Percentage Percentage Rural HHs Toilet Toilet 66,87,839 12,05,170 54,82,669 54,27,370 16,09,914 29.66% 42.10%

72 Feeling the pulse Graph 1: Year wise progress of IHHL in Karnataka

450000

400000

350000

300000

250000 BPL APL

200000

150000

100000 Number Constrcuted

50000

0 1999- 2000- 2001- 2002- 2003- 2004- 2005- 2006- 2007- 00 01 02 03 04 05 06 07 08

BPL 0 0 0 13707 14404 3427 74637 243331 328904

APL 00003350 23 138304 205865 391159

Years

However, 100 percent (35,836 as against over a limited period. The focus has been on 35,698) of the schools and over 95 percent change of collective mind set and attitudes of anganwadis (22,998 as against 24,086) (‘transformation of a culture’ according have been provided with sanitary toilets. to EO, Thirthelli) through well thoughout TSC is currently being implemented in 5,654 IEC rather than construction of toilets. gram panchayats. While 121 NGPs have been Conscious efforts have been made to reach awarded to the state so far, almost 639 GPs a critical mass during the follow up as a and 12 Taluk panchayats have submitted result of emulations and peer pressure. applications for the award for the year 2007- District Shimoga is a true example of what 08. In fact the coastal and Malnad districts concerted IEC could achieve. The experience of the state are reportedly heading towards of the project has been that once the being declared as ODF districts. community and the key functionaries are involved in IEC resistance is relatively less. Dedicated and willing leadership at the Key Findings district level has been a critical factor in Adoption of a ‘campaign’ approach has initiating and sustaining the campaign and been effective. Intense, defi ned and enabling commitment to percolate down to planned activities have been undertaken the block and GP level.

Karnataka 73 Synergy at all level (Departmental, PRI, protect ones honour’ have been successful community) has been one of the important in driving home the importance of usage of aspects of programme implementation. toilets in everyday life, thus managing to Establishing multi level, multi-stakeholder convert the mindset of the people thereby teams for IEC; integration of offi cials radically transforming old habits. and functionaries (education, ICDS, Production centers have been set up at Adhyaksha, Upadhyaksha etc,) especially the grass root level. In district Shimoga at the block and GP level, ensured better supply chain has been ensured through implementation and sustainability of negotiations with local dealers; some school and anganwadi sanitation and GPs have cast concrete rings for the pit hygiene. locally. Local stones have also been used Interdepartmental coordination has for lining pits and some material has been been sought throughout. Functionaries purchased from outside the taluka. Cost of of health, education and other line pan- mostly purchased from Gujarat- has departments have been roped in. 3000 reduced from Rs. 210 to Rs. 180 apparently Grameen Dak Sevaks (post man) have because of bulk orders. been trained as sanitation ambassadors. The strategy of “my ward, my Department of Information carried out responsibility” has ensured improved a multi media campaign simultaneously sense of commitment and ownership at the in 27 districts over a period of 40 days GP level and the GP teams have taken lead covering 2100 villages. in all the related activities. The block team Capacity building of TSC staff, PRI focused on IEC while GP level action plan functionaries and other stakeholders was prepared by the GP level teams as part received priority. CCDU has been set up of the training. and took the right initiatives in training Soft target based approach has been and developing communication strategy. adopted and progressive GPs have been There has been a conscious effort to handled fi rst so as to convert them into bring in commitment from all strata of the potential NGP villages. This was reportedly society i.e. women through SHGs, Youth with an aim to lend visibility, encourage through NSS. competition etc. NGP has been the focus In progressive districts the strategy of the strategy- Even the action plan adopted focused on the “village as a prepared as part of the training output was whole” thereby minimising the issues of focused on developing a potential NGP exclusion. The CEO of district Shimoga village, with all sanitation inputs including however, felt that the government household toilets, solid and liquid waste generated BPL list is a constraint rather management, etc. than a help because it did not always In Bidar district the stakeholders feel refl ect the ground situation. that the disparity between the subsidy Community participation and social amount under Jal Nirmal project ( responsibilities have reportedly been Rs. 2,000) and TSC (Rs. ,200) has the the two major factors responsible for the made mobilising the community much success of the campaign. Slogans like more difficult. In district Shimoga ‘one temple for each village’, ‘one toilet flexibility has been given to GPs to use for each house’ and ‘toilet is important to some funds from their own resources

74 Feeling the pulse (including 12th FC) to provide support, the district feels constrained in absence even to some APLs (Rs. 500/-). However of any brief to repair old toilets. The both beneficiaries as well as supply present CEO suggested that pits should side stakeholders feel that Rs. 1,200/as be constructed with NREG funds and subsidy is less as the cost of materials the funds released for improved super- have since been escalated, although structure, but the PRED Engineers refused block officials are eager to point out that to do so. the money is only an post achievement In Karnataka the PRIs do not generally incentive/reward. belong to any political parties and hence The impact/legacy of the Jal Nirmal project political interference is relatively less has served both as boon and bane: The There is no institutional mechanism for base structures and strategy are in place monitoring usage, but in some blocks this but previous levels of higher subsidy have responsibility have been handed over to come up as an obstacle to promote TSC SHGs. with a lesser subsidy. To ensure smooth fund fl ow, GPs have given temporary grants for TSC when release of funds from the centre/state is delayed. The GPs have also taken loans from SHGs to cover gaps due to delay in release of funds. Mostly single on-pit/off pit toilets have been promoted. Different kinds of pit linings were promoted to reduce costs of construction and make it affordable though at times by-passing technological safeguards. Some latrine options do not have junction chambers; there seems to Reconstructed school toilet in Bidar be gaps in awareness about emptying pits, etc. A number of latrine structures There are apparent gaps in maintenance have been erected with temporary of the school toilet facilities. For example superstructures. One can also fi nd some school in Meenkera GP, of district Bidar incomplete structures because of shortage has 3 blocks of toilets (provided under of funds with households. DPEP/SSA/TSC) all of which are in a By and large community toilets were poor state of maintenance and are not discouraged because of potential being used. Stakeholders feel that the maintenance issues. But in Bidar district state has provided a rigid design and there are plans to construct community hence there has been a lack of ownership toilets in certain areas where the (though reportedly due to lack of funds) settlement pattern is very congested. at district level to innovate on this Mobiling households to repair and use design. The district CEO of Shimoga is their existing toilets (constructed under of the opinion that GPs should use part previous programmes), was an effective of their development funds to meet the part of the campaign except in Bidar where incremental costs. Some private schools

Karnataka 75 have been persuaded to construct at In Jal Nirmal project villages TSC has to their own cost by enforcing a clause that be either gradually phased in or totally made toilets mandatory for obtaining kept out, especially where a signifi cant recognition. All anganwadis in government section of the community has already been buildings are covered with toilets and the provided with toilets under Jal Nirmal maintenance is proper. Technical improvements in HH and school In many of the school toilets the needs toilet units need to be undertaken to of girls have not been addressed. Poor ensure safe sanitation. arrangement for water in the school has Improved community based technical added to the woe. supervision and monitoring is required for There are gaps in both understanding and community ownership of the sanitation practice of handwashing amongst children. agenda. Funds earmarked for solid and liquid waste There is an urgent need to establish management have been not been utilised community based sanitary risk as yet in some districts. assessment and water quality monitoring systems. To include pit maintenance and cleaning in the information strategy- plan for construction of a second pit

Other Issues Include Focus on hand washing and hygiene promotion in schools and anganwadis, Integrate menstrual hygiene component in schools and community hygiene awareness activities, even if not included at present in TSC guidelines Upgraded toilet in Shimoga Arrangements for maintenance of school toilets- convergence with Education Emerging Issues Department There is a need to have a programme Facilitate GPs to decide on innovative use implementation strategy at the state level of subsidies including IEC and HRD strategy, which is Provide fl exible guidelines for DWSC/GPs not yet clear. to innovate according to local needs CCDU needs to be strengthened by fi lling Encourage completion/up-gradation of HH up vacant posts and training the staff toilets There is a need to revisit and revise Planned follow-up phase to be put district specifi c strategies in the light of in place to ensure sustained use and good practices from within the state such maintenance as Shimoga to facilitate smooth scaling up No specifi ed strategy to ensure inclusion of TSC. of girls and marginalised

76 Feeling the pulse 2.5 Tripura

Tripura is one of the seven states in the north eastern part of India. It is bound on the north, west, south and south-east by Bangladesh whereas in the east it has a common boundary with Assam and Mizoram. Administratively it is divided into 4 Districts, 38 Rural Development Blocks, and 962 GPs.

Largely all the TSC projects in the state received sanction during the years 2001 and 2002. The State Government started focusing on providing desired strategic support to TSC implementation in 2002-2003 onwards.

Tripura Rural Sanitation Coverage: An Overview Status At census Achievement against Overall TSC target coverage TSC Target Total No of HHs with HHs without Numbers Percentage Percentage Rural HHs Toilet Toilet 5,39,680 4,20,584 1,19,096 5,59,063 5,09,160 91.07% 91.07%

Graph 1: Year wise progress of IHHL in Tripura

250000

200000

150000 BPL APL

100000

Number Constructed 50000

0 1999- 2000- 2001- 2002- 2003- 2004- 2005- 2006- 2007- 00 01 02 03 04 05 06 07 08

BPL 0 0 0 33826 208986 35639 83643 20257 2941

APL0 0 0 0 37426 15741 18340 90 0

Years

Tripura 77 As per data available in the Government of The state government of Tripura has India’s DDWS website, state of Tripura has conveyed to Government of India, DDWS been registering 100% coverage continuously that due to the distant location of the since 2003-04. However, TSC funding is still on state and cost escalation involving high in the state. 100% coverage as per the online transportation cost, the amount allocated monitoring system refers to the baseline for the IHHL was insuffi cient. fi gures of 2000-01, when TSC was launched in Prior to April 2008 the Department of the state. Since then revised project proposals Rural Development was responsible for have been sanctioned and TSC intervention is the implementation of the programme. on-going in the state. The programme aimed Beyond April 2008 the department of to achieve physical target of 5,59,063 against Drinking Water and sanitation has been which 91.07% achievement is registered as on roped in to look after the implementation. 15th October 2008. This seems to be inspired by the perception at the state level that the The project started with an objective of technical problems related to sanitation achieving physical coverage of 5,59,063 can be better handled by an engineering toilets for 1,24,747 APL and 4,34,316 BPL line department. Thus sanitation in the households. The above graph suggests state is being seen primarily as a technical the year wise coverage of the IHHLs. Till issue. However, some of the top level September 2008 the state has managed functionaries at the district level, such as to achieve construction of 509160 toilets the District Magistrate, Dhalai see it as (1,09,281 APL and 3,99,879 BPL) which is an issue of habit and culture, therefore 91.07 % of the proposed target. Further the requiring greater attention on IEC state has constructed 3,652 school toilets activities. and 4,163 anganwadi toilets as against the The EEs and JEs are rather perplexed, as target of 4,939 and 6,024 respectively. The they are still trying to come to grips with impressive performance has won the states the issue of sanitation in a predominantly 01, 36,46 NGP awards during 2004-05, 2005- engineering domain. The EEs at the district 06 and 2006-07 respectively. The State has and JEs at the block level were not quite applied for 179 GP and 2 BP nominations familiar with the TSC norms and were not during the year 2007-08 under NGP. aware of the revised proposal. There has been a traditional practice among the population to dispose the Key Findings faecal matter in the dry pit as the open As per the Census of India 2001, the defecation in public spaces and forest coverage of the individual household toilet has been against the prevalent social in Tripura was 77.93%, which was much norm in the area. However, among the above the national average of 21.92% that interior areas of Dhalahi and North time. The practice of fi xed point defecation Tripura, some tribes still practice open in dry pit latrines was prevalent prior defecation. to the TSC with a shortfall of some 28% The IHHLs constructed under TSC in population of the tribal areas especially the the state have not been provided the backward areas of Dhalai and some part of honeycombing or brick lining in the pit due North Tripura, Dhalai having a larger share. to the escalated cost of the material.

78 Feeling the pulse In view of subsidy regime and poverty defecation, also because they fear that among the benefi ciaries the benefi ciary excessive water use would fi ll up the direct contribution in terms of money has not pit quickly. been emphasised. Cement and steel for The state government is not currently manufacturing of RCC squatting plate are concerned about the deep unlined pits provided by the state RD Department. This (made traditionally and also under the helps in reducing retail procurement thus TSC) posing threats to groundwater. There stabilising the cost of the RCC squatting is a high incidence of intestinal worms’ plate. infestation among the villagers, which The state Government earlier used to could be the result of widespread practice provide the RCC Squatting plate costing of using water from shallow well for Rs. 1,200. PVC Squatting plate at the cost drinking purposes. of Rs. 1,500 also has been provided to the With the growing number of direct pits, benefi ciaries residing in the diffi cult terrain there is reportedly a high incidence of as the RCC squatting plate weighs more malaria due to breeding of mosquitos. than 1 quintal and therefore diffi cult to The efforts to converge TSC with other transport. The pan with P-trap is fi tted in line departments have not really begun in each squatting plate placed on the unlined the state so far; the line departments are pit on bamboo frame. involved with TSC as members of the DWSC With the growing thrust on the squatting and BWSC but the inter departmental plate with water seal and P-trap, the coordination is yet to take place. larger community has started using it after Hand washing with soap or ash by removing the P-trap and making it similar people including children is a common to the traditional toilets. This has been a practice, though many schools and common practice across the state. Apart Anganwadi toilets in district Dhalai were from that there is a strong belief among in dilapidated condition with no facilities community to avoid looking at one’s own for hand washing. There have been no faeces and this was also mentioned as one systematic interventions to promote of the reasons for removal of P-trap in the hygiene education through school and squatting plates provided under TSC. The Anganwadi other reason shared by the community are The villages in the state were found to be greater quantum of water requirement for clean in general but with no proper system fl ushing the faecal matter in P-trap for solid and liquid waste management. As fi tted pan. a result, animal waste is seen on village The dry pits are dug deeper than 10 ft., as paths in some villages. The communities it is a general belief that the deeper pits also dispose the animal excreta in the will last longer. There is a general practice fi eld in which perennial farming activities of taking water for drinking purposes from continue. the shallow RCC wells. This is primarily In certain pockets of the North Tripura due to the high iron content in IM-II and district there is a practice of open IM-III Hand pumps, as reported by people defecation among the tribes that in villages. The water sources generally undertake Jhoom (shifting) cultivation being at a distance, the communities are and keep shifting their place of residence inclined to use less water for cleaning after accordingly. The villagers in district Dhalai

Tripura 79 largely use latrines except in certain pockets where tribes like Debbarman and Riang prefer to go for open defecation in the interior areas of the district The Gram Panchayat, GPVA, NGOs & WSHGs are being involved in the construction activity as per the demand, while quality control is the responsibility of AEs & JEs. The DWS is quite liberal in promoting the TSC with greater involvement of the PRIs and community institutions at the Gram Panchayat level.

Fixed point defecation in North Tripura Emerging Issues and P-traps is an issue of concern and As against the Census of India 2001 target attention. population, the state achieved 100% Working out and presenting a range sanitation coverage in rural areas in 2004-05 of technology options suited to local itself. But as per revised base line survey, conditions is essential to help people the state has achieved a coverage of 91.07% make informed choices. by the end of September, 2008. Despite the There are visible gaps in hand washing impressive coverage, a lot still needs to be and hygiene promotion that underscore done to optimise the full benefi ts of TSC in the need for added emphasis on the rural areas of the state by way of desired hygiene education. public health outcomes. The emerging issues in this regard are as follows: As the responsibility for sanitation has Linkage between sanitation, health been recently (in April 2008) transferred to and hygiene needs to be more sharply the Department for Drinking Water Supply addressed through communication and Sanitation (DDWS) from Department of campaigns and capacity development Rural Development, DDWS staff needs to initiatives. be oriented in demand driven approaches Sustainability and maintenance of and trained in community mobilisation and the dry pit toilets with out water seal hygiene promotion activities.

80 Feeling the pulse References

1. AFC, (2005), TSC Mid-Term Evaluation Study, March http://ddws.nic.in/publications.htm

2. Caroline Hunt; Human Development Report (2006); (Occasional paper) Sanitation And Human Development

3. Department of Drinking Water and Sanitation website www.ddws.nic.in

4. Ferroni Marco and Ashoka Mody, World Bank (2002), International Public Goods: Incentives, Measurement and Financing

5. GoI (2003), Towards Total Sanitation and Hygiene: A Challenge for India, India Country Paper at South Asian Conference on Sanitation, Dhaka, Bangladesh, October

6. GoI, RGNDWM, DDWS, MoRD, (2004); Revised TSC Guidelines, January http://ddws.nic.in/publications.htm

7. GoI, RGNDWM, DDWS, MoRD (2007); Guidelines, Central Rural Sanitation Programme, Total Sanitation Campaign, December http://ddws.nic.in/publications.htm

8. Human Development Report (2006) Beyond Scarcity – Power, Poverty and the Global Water Crisis

9. IIMC (1998), Water and Sanitation: A Baseline Survey; Indian Institute of Mass Communication, January

10. Millennium Development Goals; Indian Country Report (2005)

11. Water Aid, India (2005); Drinking Water and Sanitation Status in India – Coverage; Financing and Emerging Concerns.

12. WHO (2004) Publication The Sanitation challenge: Turning Commitment into Reality

13. WSP-SA (2005) Scaling-Up Rural Sanitation in South Asia: Lessons Learnt from Bangladesh, India and Pakistan, May

References 81 Glossary

Total Sanitation Campaign (TSC) National reform programme in rural sanitation launched by Government of India in 1999. Block Panchayat/Janpad Panchayat Intermediary tier of local self government that contains a number of GPs Central Rural Sanitation Programme The fi rst national rural sanitation programme launched by (CRSP) Government of India in 1986. Civil Society Organisations (CSOs) People’s institutions including NGOs and community based organisations (CBOs) such as self help groups (SHGs) of women, Mahila Mandals, Youth Clubs etc. Community Led Total Sanitation An integrated approach to achieving and sustaining open (CLTS) defecation free (ODF) status of communities. CLTS entails the facilitation of the community’s analysis of their sanitation profi le, their practices of defecation and the consequences, leading to collective local action to become ODF. Communication and Capacity A unit set up at the State level with funding from Government Development Unit (CCDU) of India to provide communication and capacity building support for water and sanitation sector ddws.nic.in Offi cial website of Department of Drinking Water Supply, Ministry of Rural Development, Government of India Gram Panchayat (GP) Foundation of local self government. It may consist of one or more revenue villages as recognised by revenue administration that could further comprise of one or more habitations. Information, Education and Information, Education and Communication (IEC) is an Communication (IEC) important component of the TSC programme, which intends to create the demand for sanitary facilities in the rural areas. It seeks to educate the public; create awareness among them regarding good health and proper hygiene; provide solutions to areas in need; build alliances with like minded organisations and the community as a whole; and create long term success by facilitating community involvement and ownership.

Lohiya Swachchhata Yojana (LSY) State sanitation scheme of Government of Bihar to provide incentive to households, both APL and BPL, for construction of latrines National Rural Health Mission National Rural Health Mission is a fl ag-ship programme (NRHM) launched by Government of India for the period 2005-2012 to be implemented in 18 states with weak public health indicators & infrastructures. The mission adopts a synergistic approach by relating health to determinants of good health namely, segments of nutrition, sanitation, hygiene and safe drinking water. It also aims at mainstreaming the Indian systems of medicine to facilitate health care.

82 Feeling the pulse Nirmal Gram Puraskar A national award scheme of Government of India (initiated in June 2003) to award GPs, Block Panchayats and Zila Panchayats for sanitation outcomes in terms of achieving open defecation free and fully sanitised environment. Eligible Gram Panchayats, Blocks and Districts will be those that achieve (a) 100% sanitation coverage of individual households, (b) 100% school sanitation coverage, (c) free from open defecation, and (d) clean environment maintenance. Also eligible for the award will be the individuals and organisations, which have been the driving force for effecting full sanitation coverage in their respective geographical areas. Open Defecation (OD) Defecating in the open and leaving the stuff exposed. Open Defecation Free (ODF) ODF means safe confi nement of human excreta; where no faeces are openly exposed to the air. A direct pit latrine with no lid is a form of open defecation (fi xed point open defecation), but with a fl y-proof lid (with or without the use of ash to cover the faeces after defecation) qualifi es as ODF. Panchayati Raj Institutions Institutions of local self government in India, PRA Participatory rural appraisal (PRA) is an approach used by non-governmental organisations and other agencies involved in international development. The approach aims to incorporate the knowledge and opinions of rural people in the planning and management of development projects and programmes. (PRIs) Comprising GP, Block Panchayat and Zila Panchayat as its lowest, middle and upper tiers. Production Center (PC) Production Centers are production units for cost effective affordable sanitary materials. Rural Sanitary Mart (RSM) Rural Sanitary Mart is an outlet dealing with materials required for construction of not only sanitary latrines but also other sanitary facilities required for individuals, families and schools in the rural areas. The main aim of having a RSM is to provide materials and guidance needed for constructing different types of latrines and other sanitary facilities, which are technologically and fi nancially suitable to the rural areas. Sant Gadge Baba Swachchhata State sanitation scheme of Government of Maharashtra to Abhiyan (SGBSA) reward GPs based on certain indicators related to sanitation and good governance South Asia Conferences on South Asia Conferences on Sanitation are high-powered Sanitation (SACOSAN) ministerial conferences held in South Asian region, devoted solely to the subject of sanitation. Sarpanch Elected head of a GP

Glossary 83

Annexes

Annex I: List of GPs visited

Date District Block GP Village Chhattisgarh 29th May 2008 Sarguja Bhaiyathan Rai Peepar Para 30th May 2008 Sarguja Lundra Purkela Purkela 30th May 2008 Sarguja Lundra Mahora Mahora 31st May 2008 Sarguja Bhaiyathan Kaskela Kaskela 1st June 2008 Dhamtari Dhamtari Gujara Gujara 2nd June 2008 Dhamtari Nagri Chinwarri Chinwarri 2nd June 2008 Dhamtari Nagri Deopur Deopur 3rd June 2008 Dhamtari Dhamtari Kharenga Kharenga Bihar 3rd July 2008 Vaishali Raja Pakar Rampur Ratnakar Fatehpur Phulwariya 3rd July 2008 Vaishali Raja Pakar Bhulai Alipur 4th July 2008 Vaishali Bidupur Mayil Mayil 4th July 2008 Vaishali Bidupur Daud Nagar Daud Nagar 6th July 2008 Nalanda Giriyak Ghosrawan Rani Sarai 6th July 2008 Nalanda Giriyak Giriyak Giriyak 8th July 2008 Nalanda Rajgir Pilkhi Pilkhi 8th July 2008 Nalanda Rajgir Nahu Newada Haryana 23rd July 2008 Mewat Hathin Bajada Pahari Bajada Pahari 24th July 2008 Mewat Hathin Ferozpur Rajput Ferozpur Rajput 24th July 2008 Mewat Hathin Malokhada Malokhada 25th July 2008 Mewat Nagina Nautki Nautki 25th July 2008 Mewat Nagina Santhawadi Santhawadi 28th July 2008 Sirsa Raniya Sultanpuria Sultanpuria 29th July 2008 Sirsa Raniya Fatehpuria Fatehpuria 29th July 2008 Sirsa Raniya Dhani Pratap Singh Dhani Pratap Singh 29th July 2008 Sirsa Alnabad Ummedpura Ummedpura 30th July 2008 Sirsa Baraguda Burj Karam Garh Burj Karam Garh 30th July 2008 Sirsa Baraguda Mallewala Mallewala Karnataka 11th July 2008 Shimoga Shikaripura Nellavagellu Nellavagellu 11th July 2008 Shimoga Shikaripura Churchiyundi Churchiyundi 12th July 2008 Shimoga Thirthelli Melinakurravali Melinakurravali 12th July 2008 Shimoga Thirthelli Mullubagilu Mullubagilu 15th July 2008 Bidar Homnabad Mana-e-khelli Mana-e-khelli 15th July 2008 Bidar Homnabad Ghatboral Ghatboral

Annex I 87 Date District Block GP Village 16th July 2008 Bidar Aurad Torna Torna 16th July 2008 Bidar Aurad Hedgapur Hedgapur Tripura 19th Aug 2008 North Tripura Gournagar Bhagaban Nagar Bhagaban Nagar 20th Aug 2008 North Tripura Kumarghat Radha Nagar Radha Nagar 20th Aug 2008 North Tripura Kumarghat Betchera Betchera 20th Aug 2008 North Tripura Kumarghat Darchavi Tatipara 21st Aug 2008 Dhalai Salema Barlottama Barlottama 21st Aug 2008 Dhalai Salema Salema Salema 22nd Aug 2008 Dhalai Ambassa Jawaharnagar Jawaharnagar 22nd Aug 2008 Dhalai Ambassa Jagannathpur Jagannathpur

88 Feeling the pulse open % HHs defecating in have toilets out of those who % HHs using toilets using toilets % HHs having toilet having toilet GP Block 100 100 0 Percentage (%) of Households having toilets, using toilets and defecating in the open (%) of Households having toilets, using toilets and defecating in the open Percentage District Annex II: Primary Data on Household Toilets and Usage II: PrimaryAnnex Data on Household Toilets 5678 Nalanda Nalanda Giriyak Nalanda Giriyak Nalanda Rajgir Ghosrawan Rajgir Giriyak Pilkhi NGP-07-08 Nahu 90 10 50 10 13 55 70 60 60 93 94 92 4 Vaishali Bidupur Daud Nagar 44 65 71 23 Vaishali Vaishali Pakar Raja Bidupur Bhulai Mayil NGP-05-06 90 38 50192021 Mewat 55 20 Mewat Mewat Hathin Nagina Nagina Malokhada Nautki 92 Santhawadi 10 10 24 40 50 30 96 95 92 Sl No Bihar 1 Vaishali Pakar Raja Ratnakar Rampur Chhattisgarh 9101112 Sarguja1314 Sarguja Bhaiyathan 9015 Rai Sarguja16 Lundra SargujaHaryana Dhamtari Lundra17 Bhaiyathan Dhamtari Purkela Dhamtari Kaskela18 Dhamtari Mahora Nagri Gujara Dhamtari Nagri 70 Dhamtari NGP-07-08 Mewat Chinwarri NGP-07-08 Kharenga Mewat Deopur NGP-07-08 Hathin NGP-07-08 Hathin 37 100 Bajada Pahari 100 Rajput Ferozpur 99 100 100 100 100 99 70 95 75 94 96 100 0 0 30 40 25 0 6 100 100 60 100 0 0

Annex II 89 open % HHs defecating in have toilets out of those who % HHs using toilets using toilets % HHs having toilet having toilet NGP-07-08 97 100 0 GP Singh Block Kumarghat Darchavi 100 100 0 Kumarghat Betchera 100 100 0 Kumarghat Nagar Radha 100 100 0 Gournagar Bhagaban Nagar 100 100 0 District Tripura Tripura Tripura Tripura 40414243 Dhalai Dhalai Dhalai Salema Salema Ambassa Barlottama Salema Jawaharnagar Ambassa Jagannathpur NGP-06-07 100 100 100 100 100 100 88 85 0 0 12 15 39 North 38 North 37 North Sl No 222324 Sirsa Sirsa Sirsa RaniyaKarnataka Raniya28 Raniya29 Sultanpuria30 Fatehpuria31 Dhani Pratap NGP-07-0832 Shimoga NGP-07-0833 Shimoga Shikaripura34 Shimoga Nellavagellu Shikaripura35 Shimoga Churchiyundi Thirthelli 99Tripura Bidar Thirthelli36 Bidar Melinakurravali 99 NGP-06-07 Bidar Mullubagilu NGP-06-07 Homnabad Bidar Mana-e-khelli Homnabad Ghatboral Aurad North 100 Aurad 98 100 100 Torna 100 Hedgapur 1 100 100 100 1 54 100 18 2 100 0 54 60 0 39 50 0 68 85 25 91 54 92 252627 Sirsa Sirsa Sirsa Alnabad Baraguda NGP-07-08 Ummedpura Baraguda Garh Burj Karam NGP-07-08 Mallewala 100 NGP-07-08 100 97 99 100 100 1 0 3

90 Feeling the pulse nement of human excreta. However, for the However, nement of human excreta. pit latrines single direct These are xed point defecation in what was locally being called ‘kuccha latrines’ The data in the above table is compiled from FGD responses of groups of men, women, and children from the 40 GPs. There There from the 40 GPs. of groups men, women, and children table is compiled from FGD responses The data in the above all FGDs could not be held in the locations. FGDs with women, men, and mixed groups of men women. However, were as well. FGDs with children were In some places there was no evidence of open defecation and all the district, there Tripura all the GPs visited in North Tripura, In case of households had fi purposes of coverage, these households have been regarded as covered, as all the members of household use these as covered, these households have been regarded purposes of coverage, (Salema Block) and Jawahar Nagar (Ambasa of toilets and do not go out in the open for defecation. In Salema GP communities respectively. was found some evidence of open defecation in tribal and Bihari migrant Dhalai district, there cement/ concrete ‘pucca toilets’ for which pre-fabricated by being replaced ‘kuccha toilets’ are Tripura, in TSC Under households with some monetary help for to BPL have been provided plastic squatting plates along with pans P-traps as well in some places. superstructure GPs,Out of 15 NGP while in 9 GPs of open defecation was still on. 6 GPs found to be open defecation free, the practice were GPs still not open defecation free. this limited sample size, 60% of the NGP Within are with no wall linings and water seals/P-traps and cannot be considered safe confi and cannot be considered with no wall linings and water seals/P-traps Note 1. 2. 3. 4.

Annex II 91 Annex III: Study Framework and Tools

Objectives of the Study Encourage cost effective and appropriate 1. effectiveness of the campaign in taking technologies in sanitation. forward the goal of total sanitation in Eliminate open defecation to minimise risk a given time frame and with available of contamination of drinking water sources resources and food. 2. extent to which the campaign has Convert dry latrines to pour fl ush latrines, succeeded in conveying the intended and eliminate manual scavenging practice, benefi ts of sanitation to the community wherever in existence in rural areas. and inducing the required behaviour change for the sustainability of the Objectives of TSC – December 2007 campaign Guidelines 3. NGP villages 4. barriers and drivers for the campaign The main objectives of the TSC are as under: 5. role of women a. Bring about an improvement in the general 6. policy implications for improved quality of life in the rural areas. implementation b. Accelerate sanitation coverage in rural 7. TSC vis-à-vis MDG commitments areas to access to toilets to all by 2012. c. Motivate communities and Panchayati Objectives of TSC – January 2004 Raj Institutions promoting sustainable Guidelines sanitation facilities through awareness creation and health education. The main objectives of the TSC are as under: d. In rural areas, cover schools by March Bring about an improvement in the general 2008 and Anganwadis by March 2009, with quality of life in the rural areas. sanitation facilities and promote hygiene Accelerate sanitation coverage in rural areas. education and sanitary habits among Generate felt demand for sanitation students. facilities through awareness creation and e. Encourage cost effective and appropriate health education. technologies for ecologically safe and Cover schools/Anganwadis in rural areas sustainable sanitation. with sanitation facilities and promote f. Develop community managed hygiene education and sanitary habits environmental sanitation systems focusing among students. on solid & liquid waste management.

92 Feeling the pulse Study Tools some emphasis has also been laid to capture quality data through the There are six set of tools that would be designed tools and at the same time also used to capture information from lowest to ensuring coverage of desired sample to highest level of implementation. Though support the findings/observations. The the review is qualitative in nature however, tools are:

Level Tool Informants Estimated Time State T-01: Discussion SWSM/UNICEF/WAI Representative 45-60 minutes with guide for State level different informants consultation District T-02: Discussion Member Secretary-DWSC/District TSC 45-120 minutes with guide for District level Coordinator/DEO/CMHO/PO-ICDS– one different informants consultation each to be covered per district Block T-03: Discussion BDO/Block TSC Coordinator/BEO/CDPO/ 30-45 minutes with guide for Block level BMO – one each to be covered per block different informants consultation Village T-04: Discussion School Teacher/AWW/GP Member – one 30-45 minutes with guide for Village level each to be covered per GP different informants consultation FGD T-05: FGD guide for Community/focus group – one per GP or 90-120 minutes with community level 8 per state focus group consultation Household T-06: Discussion guide 10 households per GP or 80 per state 45-60 minutes with for Household level with purposive selection of three women each household consultation headed HH; one from each category– With toilets (3 nos.) With non-functional toilets (3 nos.) Without toilets (4 nos.)

Annex III 93 Reference to to Reference Tools T-01/T-02 T-03/T-04/T- 05/T-06 T-01/T-02 T-03/T-04/ Level at which Level it would be measured State/District Block/Village/ community/ Household State/District T-01/T-02 State/District Block/Village Monthly Progress Report 31, (as of March 2008) Monthly Progress Report; Annual Audit (as Report 31, of March 2008) Information Source/ Document PIP/ Institutional Framework, Communication and Capacity Building Plan (CCBP) SWSM Member Secretary DWSC, District TSC coordinator, SWSM Member Secretary DWSC, District TSC coordinator, Informants SWSM Member Secretary DWSC, District TSC coordinator, level of operation. annual funds State) Indicators/Sub Parameters Coverage • IHHL/SSC/AWSC/WSC • APL/BPL • SC/ST • headed family Women Achievement vis-à-vis targets • Physical • Financial • Gap to sanction date) respect (With Availability Availability Resource • at all Envisaged human resources • of budgeted (GoI/ release Timely Parameters to to Parameters be measured Effectives of TCS TCS Effectives of campaign Timeframe Available resources lable

esources Study Study Objective Obj-1: Effectiveness of the campaign in taking the forward goal of total sanitation in a given time and frame with avai r Logical Framework for Information Collection Information for Logical Framework

94 Feeling the pulse Reference to to Reference Tools T-03/T-04/ T-05/T-06 T-05/T-06 T-05/T-06 Level at which Level it would be measured District/Block GP Community/ Household Community/ Household Monthly Progress Report; Tools Tools available Reports documents Tools available Reports documents Information Source/ Document Community/ Household CMHO/ CMO/BMO/ MO-PHC Community Community/ Household Informants why & why level – how and status – arrangement drinking water sources opinion of HH drinking water – how & why drinking water – how • & why No open defecation - how • Disposal of solid/liquid waste at HH • Cleanliness of village lanes & drains • Platforms and water-logging around • of water borne diseases Prevalence • DD incidences amongst U5 children • Expenditure on health • of environmental sanitation Status Indicators/Sub Parameters & Understanding Awareness • of key messages Recall • for having & using toilets. Reasons • What is safe drinking water in • & handling of Collection, storage Adoption of Practices • practice availability & usage Toilet washing • Hand defecation open • No • Solid & liquid waste management • – when & Hand washing practice ts Induced Behaviour Change Impact/ Outcome Parameters to to Parameters be measured Intended Benefi Extent ts of ts Study Study Objective Obj-2: to which the campaign has succeeded in conveying the intended benefi sanitation to the community and inducing the required behaviour change for the sustainability of the campaign

Annex III 95 T-05 T-03/T-04/ T-03/T-04/ T-05 T-03/T-04/ T-05 Reference to to Reference Tools District/Block GP District/Block GP District/Block GP Level at which Level it would be measured Tools Monthly Progress Report; Monthly Progress Report; Tools Tools Monthly Progress Report; Information Source/ Document Different Different stakeholders Different Different stakeholders DEO/PC- SSA/BEO Community Informants cials, NGOs, cials, for HH level Strategy options & supplies approach etc.) CCDU/SPMU/DWSC/DPMU/BWSC Institutional Frame Work – SWSM/ Work Institutional Frame and mindset towards sanitation and mindset towards in particular TSC and in general offi – government PRIPartners, & community supplies level • SSHE Action Plan • for technology Strategy State NGOs/CBOs • of Plan for tribal areas. • Involvement • Community led & demand driven • targets TSC subsidies vis-à-vis Govt. • & incentive schemes Reward • mechanism & reporting Review • (Unicef/WAI Support from Partners • Communication & Capacity Building • policy vis-à-vis subsidies Govt. • based approach Target • Availability of technology options & • of the community Preference • Availability of water supply • for toilet construction at HH Funds • Adequate water supply in toilets • availability for O&M Funds • for cleaning of toilets Arrangement • education for children Hygiene Refer Obj-2 Refer Indicators/Sub Parameters School/AWC • & girls toilets blocks for boys Separate Drivers • Barriers • to change) Attitude (resistance Parameters to to Parameters be measured Assessment of village NGP

Obj-4: barriers and drivers for the campaign Study Study Objective Obj-3: villages NGP

96 Feeling the pulse T-01/T-02 T-03/T-04/T- 05/T-06 T-05/T-06 Reference to to Reference Tools T-05/T-06 State/District Block/Village/ community/ Household Community/ Household Level at which Level it would be measured Community/ Household Tools available Reports documents Tools available Reports documents Tools available Reports documents Information Source/ Document Community/ Household Different stakeholders Community/ Household Informants uence of women in the small government incentives the small government available and the actual cost of building latrines – a problem for low- income households and bridge the available resources gap to achieve targets resource within timeframe privacy for women additional tasks like water availability and cleaning of toilets Sanitation Policy change and bring about behavioural numbers of households and in large individuals/community on sanitation in women headed GPs toilets adoption & promotion of safe at the HHhygiene practices level • to make the best use of How • to bridge the gap between How • Safety, security, convenience & convenience security, • Safety, • Change in daily routine for • document and/or National Vision • demand for sanitation to create How • CBOs – number & initiatives Women • Community initiatives on sanitation • headed HH Women having & using infl & • Role Indicators/Sub Parameters Impact on Women Policy Implications for improved implementation Parameters to to Parameters be measured Participation/ Involvement of Women Obj-6: policy implications for improved implementa– tion Study Study Objective Obj-5: role of women

Annex III 97 Reference to to Reference Tools T-01/T-02 T-03/T-04/T- 05/T-06 Level at which Level it would be measured State/District Block/Village/ community/ Household Tools available Reports documents Information Source/ Document Different Different stakeholders Informants Indicators/Sub Parameters • Trajectory of TSC. • Overlap of commitments. of • Trajectory Parameters to to Parameters be measured Study Study Objective Obj-7: vis-à- TSC vis MDG commitments

98 Feeling the pulse Annex IV: FGD Guide for Community Level Consultation

(Can be used for Men/Women/Children) Profi le

F1. General profi le of the village – population, houses, caste structure, occupation structure, crop pattern etc. F2. Facilities in the village – electricity, school, anganwadi, health center, PDS shop etc.

Understanding

F3. Understanding of a clean village – what, why, components. F4. Disease profi le – water borne diseases, occurrence rate, reasons, expenses involved, impact on health, economic & social status. F5. Way out – safe drinking water, toilets, hygiene practices, garbage & waste water management. F6. What is ODF community/Nirmal Gram? Is it required? Why? How?

Drinking Water

F7. Drinking water – availability, accessibility, quality & quantity. F8. O&M of sources – mechanism, frequency, cost, contributions.

Household Toilets

F9. Toilet availability & usage - extent, reasons & benefi ts of usage. F10. Type of toilet – pit, pan, superstructure. F11. Cost of toilet – free, subsidised– labour/cash/kind, personal cost, when built. F12. Problems faced in construction. Money, material, design, mason. F13. Usage pattern – who uses, who does not & why, who cleans. F14. Problems faced in maintenance – water, cleansing agent, technical, other. F15. Reasons and risks of not having/using toilets. F16. Future plans–did someone reinforce, intention, help needed–what & why. F17. Any support extended by CBO/SHG/GP.

Hygiene Practices

F18. Hand washing practice – when why, cleansing agent. F19. Water handling practice – collection, storage, handling, who does it. F20. Household cleanliness – garbage, wastewater, food, who does it. F21. Village sanitation – garbage & wastewater.

Annex IV 99 Communication

F22. Who motivated? Message, incentive, attraction, frequency. (Explore IPC). F23. Communication activities – when, who did them, message, frequency.

Anganwadi Sanitation

F24. Number of AWC in the village? Number of children? F25. Does all the AWC have child friendly toilets, water supply & hand washing facility? F26. Are toilets accessible for students or are under lock and key? How the children use it? F27. Who cleans the toilets in anganwadi? What is the O&M arrangement in the anganwadi? F28. How many supervisors/AWW/Sahayika have and use toilets?

School Sanitation

F29. Till what level is the village school – primary, secondary, higher secondary? F30. Number of students in the school – boys/girls. F31. What facilities are available in the school – toilet, water supply & hand washing? F32. Are toilets accessible for students or are under lock and key? How the children use it? F33. Who cleans the toilets in schools? What is the O&M arrangement in the schools? F34. How many teachers, PTA/MTA/VEC members have and use toilet? F35. Are the hygiene education classes held? What is the content?

100 Feeling the pulse Notes Notes

WaterAid – Water for Life The UK’s only major charity dedicated exclusively to the provision of safe domestic water, sanitation and hygiene education.

WaterAid Recognising water and sanitation as basic human rights and the foundation for overall development

WaterAid is an international charity established in 1981. Its vision is to enable poor communities gain access to safe and adequate water and sanitation. Presently, WaterAid works in 17 countries across Asia, Africa and the Pacific region. It operates through local partners, helping them set up low cost sustainable projects that can be managed by the community themselves.

WaterAid believes that water, sanitation and hygiene education are vital for the health, well being and dignity of poor people and provide the foundation for development and poverty reduction.

WaterAid in India

WaterAid started working in India in 1986. Since 2003, WAI shifted its focus from Southern India to include the poorer states in the north to better target India’s most vulnerable communities. Keeping that in mind, the country office was shifted to the nation’s capital, New Delhi.

Currently, WaterAid India (WAI) works in the ten states of Andhra Pradesh, Bihar, Chhattisgarh, Delhi, Jharkhand, Karnataka, Madhya Pradesh, Orissa, Tamil Nadu and Uttar Pradesh.

WAI’s objectives are to Enable improved access to sustainable, safe and adequate water supply and sanitation through water, sanitation, health and hygiene projects Creation of a knowledge base for promotion and dissemination of best practices and advocacy at different levels for policy improvement towards sustainable health and hygiene benefits Develop and foster an enabling environment for effective programme implementation, in-country funding, organisational learning and growth

WAI also has liaison offices in Bhopal, Bangalore, Bhubaneswar and Lucknow

India WASH Forum

India WASH Forum (IWF) is a Trust affiliated to the Water Supply & Sanitation Collaborative Council, Geneva, Switzerland. It is a membership based coalition of Indian organisations and individuals working on water, sanitation and hygiene.

India Liaison Office C-3, 1st Floor, Nursery School Building Nelson Mandela Marg, Vasant Kunj New Delhi - 110 070 Additional Liaison Office North Ph: 011-46084400; Fax: 011-46084411 Additional Liaison Office East 2/203, Vishal Khand, Gomti Nagar email: [email protected] Plot No. 1266, Bhoi Nagar, Unit IX Lucknow - 226010, Uttar Pradesh Bhubaneswar - 751 022, Orissa Ph: 0522-4065412 Ph: 0674-2531266; 2531267 email: [email protected] email: [email protected] www.wateraid.org

Additional Liaison Office South Additional Liaison Office West 609, 2nd Main, Indiranagar 7/846, Arera Colony Bangalore - 560038, Karnataka Working Areas Bhopal - 462 016, Madhya Pradesh Ph: 080-25256865; 25256870 Andhra Pradesh, Bihar, Chhattisgarh, Delhi, Jharkhand, Ph: 0755-4294724; 4232778 email: [email protected] Karnataka, Madhya Pradesh, Orissa, Tamil Nadu, Uttar Pradesh email: [email protected]